Online Public Health Nurse-Delivered Group Cognitive Behavioral Therapy for Postpartum Depression: A Randomized Controlled Trial During the COVID-19 Pandemic
Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for PPD. While public health nurses (PHNs) can be trained to help treat PPD, it is not known if they can effectively deliver evidence-based psychotherapies...
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| Vydané v: | The journal of clinical psychiatry Ročník 84; číslo 5 |
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| Hlavní autori: | , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
United States
24.07.2023
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| ISSN: | 1555-2101, 1555-2101 |
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| Abstract | Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for PPD. While public health nurses (PHNs) can be trained to help treat PPD, it is not known if they can effectively deliver evidence-based psychotherapies online to those with PPD.
Mothers (n = 159) living in Ontario, Canada, with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 and an infant < 12 months of age were randomized to receive a 9-week group cognitive behavioral therapy (CBT) intervention delivered by PHNs over Zoom, between October 2020 and November 2021. Experimental group participants received CBT plus treatment as usual (TAU), and control participants received TAU alone. Participants were assessed at baseline (T1), 9 weeks later (T2), and 6 months after T2 (T3). Primary outcomes were changes in EPDS score and current major depressive disorder (MDD) as measured by the Mini International Neuropsychiatric Interview. Secondary outcomes included worry, social support, the mother-infant relationship, and infant temperament.
At T2, experimental group participants showed clinically and statistically significant reductions on the EPDS (
= 0.65) and decreases in postpartum worry (
= 0.38) and rejection and pathological anger toward their infant (
= 0.44). They were also less likely to meet diagnostic criteria for current MDD compared to control participants (OR = 5.09; 95% CI, 1.18-21.98; number needed to treat [NNT: 3.7]). These improvements remained stable 6 months later (T3).
PHNs can be trained to deliver effective online group CBT for PPD to reduce depression and worry and improve aspects of the mother-infant relationship, and they represent an important way to increase access to effective treatment for PPD.
ClinicalTrials.gov identifier: NCT04928742. |
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| AbstractList | Objective: Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for PPD. While public health nurses (PHNs) can be trained to help treat PPD, it is not known if they can effectively deliver evidence-based psychotherapies online to those with PPD.Objective: Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for PPD. While public health nurses (PHNs) can be trained to help treat PPD, it is not known if they can effectively deliver evidence-based psychotherapies online to those with PPD.Methods: Mothers (n = 159) living in Ontario, Canada, with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 and an infant < 12 months of age were randomized to receive a 9-week group cognitive behavioral therapy (CBT) intervention delivered by PHNs over Zoom, between October 2020 and November 2021. Experimental group participants received CBT plus treatment as usual (TAU), and control participants received TAU alone. Participants were assessed at baseline (T1), 9 weeks later (T2), and 6 months after T2 (T3). Primary outcomes were changes in EPDS score and current major depressive disorder (MDD) as measured by the Mini International Neuropsychiatric Interview. Secondary outcomes included worry, social support, the mother-infant relationship, and infant temperament.Methods: Mothers (n = 159) living in Ontario, Canada, with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 and an infant < 12 months of age were randomized to receive a 9-week group cognitive behavioral therapy (CBT) intervention delivered by PHNs over Zoom, between October 2020 and November 2021. Experimental group participants received CBT plus treatment as usual (TAU), and control participants received TAU alone. Participants were assessed at baseline (T1), 9 weeks later (T2), and 6 months after T2 (T3). Primary outcomes were changes in EPDS score and current major depressive disorder (MDD) as measured by the Mini International Neuropsychiatric Interview. Secondary outcomes included worry, social support, the mother-infant relationship, and infant temperament.Results: At T2, experimental group participants showed clinically and statistically significant reductions on the EPDS (d = 0.65) and decreases in postpartum worry (d = 0.38) and rejection and pathological anger toward their infant (d = 0.44). They were also less likely to meet diagnostic criteria for current MDD compared to control participants (OR = 5.09; 95% CI, 1.18-21.98; number needed to treat [NNT: 3.7]). These improvements remained stable 6 months later (T3).Results: At T2, experimental group participants showed clinically and statistically significant reductions on the EPDS (d = 0.65) and decreases in postpartum worry (d = 0.38) and rejection and pathological anger toward their infant (d = 0.44). They were also less likely to meet diagnostic criteria for current MDD compared to control participants (OR = 5.09; 95% CI, 1.18-21.98; number needed to treat [NNT: 3.7]). These improvements remained stable 6 months later (T3).Conclusions: PHNs can be trained to deliver effective online group CBT for PPD to reduce depression and worry and improve aspects of the mother-infant relationship, and they represent an important way to increase access to effective treatment for PPD.Conclusions: PHNs can be trained to deliver effective online group CBT for PPD to reduce depression and worry and improve aspects of the mother-infant relationship, and they represent an important way to increase access to effective treatment for PPD.Trial Registration: ClinicalTrials.gov identifier: NCT04928742.Trial Registration: ClinicalTrials.gov identifier: NCT04928742. Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for PPD. While public health nurses (PHNs) can be trained to help treat PPD, it is not known if they can effectively deliver evidence-based psychotherapies online to those with PPD. Mothers (n = 159) living in Ontario, Canada, with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 and an infant < 12 months of age were randomized to receive a 9-week group cognitive behavioral therapy (CBT) intervention delivered by PHNs over Zoom, between October 2020 and November 2021. Experimental group participants received CBT plus treatment as usual (TAU), and control participants received TAU alone. Participants were assessed at baseline (T1), 9 weeks later (T2), and 6 months after T2 (T3). Primary outcomes were changes in EPDS score and current major depressive disorder (MDD) as measured by the Mini International Neuropsychiatric Interview. Secondary outcomes included worry, social support, the mother-infant relationship, and infant temperament. At T2, experimental group participants showed clinically and statistically significant reductions on the EPDS ( = 0.65) and decreases in postpartum worry ( = 0.38) and rejection and pathological anger toward their infant ( = 0.44). They were also less likely to meet diagnostic criteria for current MDD compared to control participants (OR = 5.09; 95% CI, 1.18-21.98; number needed to treat [NNT: 3.7]). These improvements remained stable 6 months later (T3). PHNs can be trained to deliver effective online group CBT for PPD to reduce depression and worry and improve aspects of the mother-infant relationship, and they represent an important way to increase access to effective treatment for PPD. ClinicalTrials.gov identifier: NCT04928742. |
| Author | Layton, Haley Savoy, Calan D Van Lieshout, Ryan J Bieling, Peter J Huh, Kathryn Ferro, Mark A Hicks, Amanda |
| Author_xml | – sequence: 1 givenname: Kathryn surname: Huh fullname: Huh, Kathryn email: huhk1@mcmaster.ca organization: Corresponding Author: Kathryn Huh, BHSc, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 1812 Sir Isaac Brock Way, St Catharines, L2S 3A1, Canada (huhk1@mcmaster.ca) – sequence: 2 givenname: Haley surname: Layton fullname: Layton, Haley organization: Health Research Methodology Graduate Program, McMaster University, Hamilton, Ontario, Canada – sequence: 3 givenname: Calan D surname: Savoy fullname: Savoy, Calan D organization: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada – sequence: 4 givenname: Mark A surname: Ferro fullname: Ferro, Mark A organization: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada – sequence: 5 givenname: Peter J surname: Bieling fullname: Bieling, Peter J organization: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada – sequence: 6 givenname: Amanda surname: Hicks fullname: Hicks, Amanda organization: Niagara Region Public Health, Thorold, Ontario, Canada – sequence: 7 givenname: Ryan J surname: Van Lieshout fullname: Van Lieshout, Ryan J organization: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada |
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| CitedBy_id | crossref_primary_10_1093_oodh_oqae026 crossref_primary_10_1016_j_midw_2025_104319 crossref_primary_10_1177_08445621241276238 crossref_primary_10_1016_j_jad_2025_03_078 crossref_primary_10_1177_07067437241303031 crossref_primary_10_3390_healthcare13070696 crossref_primary_10_1016_j_jogc_2024_102680 crossref_primary_10_1016_j_jogc_2024_102681 |
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| Snippet | Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for PPD. While... Objective: Rates of postpartum depression (PPD) increased during the COVID-19 pandemic, further highlighting the need for effective, accessible treatments for... |
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| Title | Online Public Health Nurse-Delivered Group Cognitive Behavioral Therapy for Postpartum Depression: A Randomized Controlled Trial During the COVID-19 Pandemic |
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