A PILOT RANDOMIZED CONTROLLED TRIAL OF COGNITIVE BEHAVIORAL THERAPY FOR PERINATAL DEPRESSION ADAPTED FOR WOMEN WITH LOW INCOMES: Research Article: CBT for Perinatal Depression
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BACKGROUND: Perinatal women with identified depression in prenatal care settings have low rates of engagement and adherence with depression-specific psychotherapy. We report the feasibility and symptom outcomes of Cognitive Behavioral Therapy (CBT) modified (mCBT) to address the needs of perinatal, low-income women with Major Depressive Disorder (MDD). METHODS: Pregnant women (n = 1421) were screened for depressive symptoms in obstetrics clinics in conjunction with prenatal care visits. A total of 59 women met diagnostic criteria for MDD; 55 women were randomly assigned to mCBT or Treatment as Usual (TAU). The mCBT intervention included an initial engagement session, outreach, specific perinatal content and interpersonal components. Measures were gathered at pre-treatment, 16 week post-randomization, and 3-month follow-up. RESULTS: Most participants attended at least one CBT session and met study criteria for treatment adherence. Active research staff outreach promoted engagement and retention in the trial. Treatment satisfaction was rated as very good. In both observed and multiple imputation results, women who received mCBT demonstrated greater improvement in depressed mood than those in TAU at 16-week post-randomization and 3-month follow-up, Cohen's d = -0.71 (95% CI -4.93, -5.70). CONCLUSIONS: Modified CBT offers promise as a feasible and acceptable treatment for perinatal women with low-incomes in prenatal care settings. Targeted delivery and content modifications are needed to engage populations tailored to setting and psychosocial challenges specific to the perinatal period.
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In comparison with other therapeutic approaches, cognitive-behavioural therapy is provided in a wider range of intervention formats including individual, group and internet administered.
“Additionally, in comparison with other therapeutic approaches, CBT is provided in a wider range of intervention formats including; individual,32 group33 and internet administered.34”
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- Authors
- O'Mahen, H., Himle, J. A., Fedock, G., Henshaw, E., & Flynn, H.
- Affiliations
- Mood Disorder Centre; University of Exeter; Exter; UK
- University of Michigan (US)
- Michigan State University (US)
- Denison University (US)
- Florida State University (US)
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2013-01-14
- Volume
- 30
- Issue
- 7
- Pages
- 679-687
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W1891958369
- Cited by
- 136
- References
- 53
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 20 · 2023: 15 · 2022: 10 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 9 · 2016: 15 · 2015: 9 · 2014: 16 · 2013: 4
- FWCI
- 14.96
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institutes of Health (1r34mh076219-01a2)
- Medical Research Council
- National Institute of Mental Health (5R34MH076219)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- perinatal depression, cognitive behavioral therapy, major depressive disorder, low-income women, pregnant women, treatment engagement, medication adherence, research outreach, interpersonal psychotherapy, feasibility, prenatal care, depression screening
- MeSH terms
- Adult, Analysis of Variance, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Patient Compliance, Pilot Projects, Poverty, Pregnancy, Pregnancy Complications, Prenatal Care, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Patient Satisfaction, Depression, Postpartum
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