Cognitive Therapy During Pregnancy Reduces Postnatal Depression, Anxiety

Reduction seen in odds of major depressive episode, moderate-to-severe anxiety with intervention sessions delivered by nonspecialist

By Elana Gotkine HealthDay Reporter

MONDAY, March 4, 2024 (HealthDay News) — An intervention based on cognitive behavioral therapy, delivered by nonspecialist providers during pregnancy, can reduce the odds of major depression and anxiety postpartum, according to a study published online Feb. 16 in Nature Medicine.

Pamela J. Surkan, Ph.D., Sc.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues examined the effectiveness of an anxiety-focused early prenatal intervention on prevention of postnatal common mental disorders in a phase 3 trial conducted in Pakistan. Participants were ≤22 weeks pregnant with at least mild anxiety without clinical depression and were randomly assigned to the Happy Mother–Healthy Baby program, which included six one-on-one intervention sessions based on cognitive behavioral therapy and delivered by nonspecialist providers during pregnancy, or to enhanced care alone. A total of 755 women completed postnatal assessments: 380 and 375 in the intervention and enhanced care arms, respectively.

The researchers found that women randomly assigned to the intervention had reduced odds of having either a major depressive episode (MDE) or moderate-to-severe anxiety at six weeks after delivery (adjusted odds ratio [aOR], 0.19). Overall, 12 and 41 percent of participants in the intervention and enhanced care groups, respectively, developed MDE at six weeks postpartum. The odds of postnatal MDE and moderate-to-severe anxiety were reduced (aORs, 0.19 and 0.26, respectively).

“Having identified an intervention that works, the next step is to figure out the best ways to deliver effective treatment to the people who need it, bridging the gap between science and practice,” Surkan said in a statement.

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