Computer-Assisted Cognitive Behavioral Therapy for Pregnant Women with Major Depressive Disorder

Kim, Deborah R.; Hantsoo, Liisa; Thase, Michael E.; Sammel, Mary D.; Epperson, C. Neill

doi:10.1089/jwh.2014.4867

Cited by 38 publications

(35 citation statements)

References 46 publications

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“…One identified record was a ‘letter to the editor’ [ 36 ]. The corresponding author was contacted and confirmed that the data within the letter were also included in a further publication identified in the literature search [ 37 ]. In addition, the corresponding author of three articles written by the same author [ 38 – 40 ] was contacted who confirmed that all three publications included data collected from one single study.…”

Section: Methodsmentioning

confidence: 99%

Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review

Lee

Denison

Hor

et al. 2016

BMC Pregnancy Childbirth

116

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BackgroundPerinatal depression is strikingly common with a prevalence of 10–15 %. The adverse effects of perinatal depression on maternal and child health are profound with considerable costs. Despite this, few women seek medical attention. E-health, providing healthcare via the Internet is an accessible and effective solution for the treatment of depression in the general population. We aimed to conduct a systematic review of web-based interventions for the prevention and treatment of mood disorders in the perinatal period, defined as the start of pregnancy to 1 year post-partum.MethodsSix databases were searched until 26th March 2015. Two researchers independently screened articles for eligibility. Of the 547 screened articles, four met the inclusion criteria. These included three randomised-controlled trials and one feasibility trial, with total data from 1274 participants. MOOSE and PRISMA guidelines were adhered to for the conduct and reporting of the systematic review.ResultsAll studies were conducted in the post-partum period. All reported an improvement in maternal mood following intervention. A significant improvement in depressive symptoms was measured using validated rating scales, such as the Edinburgh Postnatal Depression Scale (EPDS), either at post-treatment or follow-up which ranged from 3 to 12 months post study completion. For the two RCTs utilising the EPDS, the EPDS score reductions were (mean ± SEM) 8.52 ± 0.22 (Range 19.46 to10.94) and 9.19 ± 0.63 (Range, 20.24 to 11.05) for treatment groups and 5.16 ± 0.25 (Range 19.44 to 14.28) and 6.81 ± 0.71 (Range 21.07 to 14.26) for comparator groups. However attrition within studies ranged from 13 to 61 %. One study was rated as ‘good’ quality.ConclusionsPreliminary data suggests web-based therapies for perinatal depression delivered in the post-partum period may play a role in improving maternalmood but more studies are needed, particularly with interventions delivered antenatally. Further research is needed to address the limitations of the existing evidence base.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0831-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review

Lee

Denison

Hor

et al. 2016

BMC Pregnancy Childbirth

116

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“…A recent review of treatments concluded that in terms of pharmacotherapy, SSRIs and tricyclic antidepressants had some evidence for effectiveness in treating anxiety disorders in the perinatal period (150). For women who do not want to use medication during pregnancy, cognitive behavioral therapy (CBT) may be a good alternative, particularly for women with panic disorder or specific phobias (150; 151). …”

Section: Treatment and Outcomesmentioning

confidence: 99%

Anxiety Disorders Among Women: A Female Lifespan Approach

Hantsoo

Epperson

2017

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Anxiety symptoms may present differently between women and men, and at different points in the female lifespan. The female lifespan includes distinct epochs of hormonal function, including puberty, the premenstruum, in some women pregnancy or postpartum, and the menopausal transition. These stages give rise to important treatment considerations when treating anxiety in women. When making assessments, the clinician should consider reproductive events and hormonal status, as well as sex differences in anxiety presentation. This review is structured to: 1) Define major epochs of the female lifespan, 2) Provide a brief summary of the major anxiety disorders, with a focus on prevalence and presentation in the context of sex differences and at points in the female lifespan, 3) Describe potential biopsychosocial underpinnings of anxiety disorders among women, 4) Provide guidelines for assessment and differential diagnosis, and 5) Describe treatment options with attention to reproductive events such as pregnancy.

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“…This is accomplished by a low-intensity, nontherapeutic coaching role in the case of MumMoodBooster and more frequent calls by mental health workers trained in a “high-intensity perinatal-specific BA approach” in the case of Netmums. In the antenatal period, a recently pilot-tested computerized CBT intervention for depression among pregnant women has also shown significant improvements on self-report psychometric measures [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Internet Cognitive Behavioral Therapy for Women With Postnatal Depression: A Randomized Controlled Trial of MumMoodBooster

Milgrom¹,

Danaher²,

et al. 2016

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BackgroundThere are few published controlled trials examining the efficacy of Internet-based treatment for postnatal depression (PND) and none that assess diagnostic status (clinical remission) as the primary outcome. This is despite the need to improve treatment uptake and accessibility because fewer than 50% of postnatally depressed women seek help, even when identified as depressed.ObjectiveIn a randomized controlled trial (RCT), we aimed to test the efficacy of a 6-session Internet intervention (the MumMoodBooster program, previously evaluated in a feasibility trial) in a sample of postnatal women with a clinical diagnosis of depression. The MumMoodBooster program is a cognitive behavioral therapy (CBT) intervention, is highly interactive, includes a partner website, and was supported by low-intensity telephone coaching.MethodsThis was a parallel 2-group RCT (N=43) comparing the Internet CBT treatment (n=21) to treatment as usual (n=22). At baseline and at 12 weeks after enrollment, women’s diagnostic status was assessed by telephone with the Standardized Clinical Interview for DSM-IV (SCID-IV) and symptom severity with the Beck Depression Inventory (BDI-II). Depression symptoms were measured repeatedly throughout the study period with the Patient Health Questionnaire (PHQ-9).ResultsAt the end of the study, 79% (15/19) of women who received the Internet CBT treatment no longer met diagnostic criteria for depression on the SCID-IV (these outcome data were missing for 2 intervention participants). This contrasted with only 18% (4/22) remission in the treatment as usual condition. Depression scores on the BDI-II showed a large effect favoring the intervention group (d=.83, 95% CI 0.20-1.45). Small to medium effects were found on the PHQ-9 and on measures of anxiety and stress. Adherence to the program was very good with 86% (18/21) of users completing all sessions; satisfaction with the program was rated 3.1 out of 4 on average.ConclusionsOur results suggest that our Internet CBT program, MumMoodBooster, is an effective treatment option for women clinically diagnosed with PND. This is one of only two controlled evaluations of specialized online psychological treatment among women clinically diagnosed with PND. MumMoodBooster appears to be a feasible, effective treatment option, which is potentially accessible to large numbers of women in metropolitan, rural, and remote areas. Future work might be focused profitably on establishing comparability with face-to-face treatments and purely self-guided delivery. We have commenced a larger RCT comparing MumMoodBooster with face-to-face CBT.Trial RegistrationAustralian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000113752; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363561 (Archived by WebCite® at http://www.webcitation.org/6f64kuyLf).

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Computer-Assisted Cognitive Behavioral Therapy for Pregnant Women with Major Depressive Disorder

Cited by 38 publications

References 46 publications

Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review

Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review

Anxiety Disorders Among Women: A Female Lifespan Approach

Internet Cognitive Behavioral Therapy for Women With Postnatal Depression: A Randomized Controlled Trial of MumMoodBooster

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