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Internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period

Published online by Cambridge University Press:  19 July 2023

D. Nishi*
Affiliation:
1The University of Tokyo, Tokyo
K. Imamura
Affiliation:
1The University of Tokyo, Tokyo
K. Watanabe
Affiliation:
2Kitasato University, Sagamihara
E. Obikane
Affiliation:
3National Center for Child Health and Development, Tokyo
N. Sasaki
Affiliation:
1The University of Tokyo, Tokyo
N. Yasuma
Affiliation:
4Ageonomori Clinic, Ageo, Japan
Y. Sekiya
Affiliation:
1The University of Tokyo, Tokyo
Y. Matsuyama
Affiliation:
1The University of Tokyo, Tokyo
N. Kawakami
Affiliation:
1The University of Tokyo, Tokyo
*
*Corresponding author.

Abstract

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Introduction

Prevention of perinatal depression beginning from the antenatal period is essential.

Objectives

This study aimed to investigate the effectiveness of recently developed internet-delivered cognitive behavioral therapy (iCBT) for preventing the onset of a major depressive episode (MDE) in the third trimester and at 3 months postpartum.

Methods

This is a two-arm, parallel-group, general-information controlled, randomized controlled trial. Participants were 5,017 pregnant women at 16–20 weeks’ gestation without MDE at baseline. They were randomly assigned to an iCBT (intervention; n = 2,509) or general-information (control; n = 2,508) group, stratified by psychological distress at baseline. The primary outcomes were the numbers of new MDE onsets, measured using the World Health Organization Composite International Diagnostic Interview 3.0, at 32 weeks’ gestation and at 3 months postpartum.

Results

New MDE onset was reported by 59 participants (2.35%) in the intervention group and 73 (2.91%) in the control group during follow-up. Compared with the control group, the hazard ratio (HR) of MDE in the intervention group was 0.85 (95% CI 0.61–1.20). Among participants who scored between 5 and 8 on K6 at baseline, 10 (1.37%) in the intervention group reported new onset of MDE, compared with 28 (3.81%) in the control group, and the HR of MDE was 0.38 (95%CI 0.19–0.79).

Conclusions

No intervention effect was found for iCBT in preventing new onset of perinatal MDE. iCBT might prevent perinatal depression only among pregnant women with subthreshold depressive symptoms.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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