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Cited by 223Maternal Mental Health During Pregnancy and PostpartumMindfulness and Compassion InterventionsPersonality Disorders and Psychopathology

Staying well during pregnancy and the postpartum: a pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence

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Dimidjian, Sona, Goodman, Sherryl H., Felder, Jennifer N., Gallop, Robert, Brown, Amanda P., Beck, Arne·2016·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000068PMC PMC5718345
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Abstract

OBJECTIVE: Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their health care providers. Pregnant women with histories of depression report preference for nonpharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU). METHOD: Pregnant adult women with depression histories were recruited from obstetric clinics at 2 sites and randomized to MBCT-PD (N = 43) or TAU (N = 43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6 months postpartum. RESULTS: Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared with participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study. CONCLUSIONS: MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive-behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in many women's lives.

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  • MBSR and similar mindfulness-based interventions (MBIs) have been shown efficacious at reducing depressive and anxiety symptoms in pregnancy and postpartum, but sleep quality was not a key outcome in these studies.

    “MBSR and similar mindfulness-based interventions (MBIs) have been shown efficacious at reducing depressive and anxiety symptoms in pregnancy and postpartum, but sleep quality was not a key outcome in these studies [12, 13].”

    From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [12]

    The Results (page unavailable) report significantly lower depressive-symptom severity with MBCT-PD than with usual care among pregnant women with histories of depression, followed through six months postpartum. The Method > Measures section (page unavailable) identifies depression outcomes but no sleep-quality outcome. This trial did not establish reductions in anxiety symptoms or test MBSR itself, so it supports only part of the broader claim. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Given the demonstrated benefit of mindfulness training in pregnancy for improving depression symptoms and preventing depression relapse, mindfulness may be especially suited, in combination with CBT-I, for treating insomnia in pregnant women with a history of depression.

    “Given the demonstrated benefit of mindfulness training in pregnancy for improving depression symptoms and preventing depression relapse [12, 20], mindfulness may be especially suited, in combination with CBT-I, for treating insomnia in pregnant women with a history of depression.”

    From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [12]

  • There is strong evidence that perinatal mental health conditions can be prevented and effectively treated through psychotherapy and/or pharmacotherapy.

    “Importantly, there is strong evidence that PMH conditions can be prevented52-54 and effectively treated through psychotherapy54-57 and/or pharmacotherapy.58,59”

    From The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact (2022) · cites this paper as [54]

  • Only preliminary evidence exists to indicate that complementary health approaches-such as folate supplementation, yoga, and mindfulness-are safe, feasible, and acceptable for perinatal women and have the potential for improving depressive symptoms; there are well-documented protective effects of folate against the development of neural birth defects.

    “Only preliminary evidence exists to indicate that complementary health approaches—such as folate supplementation (yet there are well-documented protective effects of folate against the development of neural birth defects51), yoga, and mindfulness—are safe, feasible, and acceptable for perinatal women and have the potential for improving depressive symptoms.48,52–55”

    From Perinatal Depression: Challenges and Opportunities (2021) · cites this paper as [54]

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Research works printed but not linked: 2

  1. First MB Miriam G Spitzer RL Williams JBW Lorna B 1997 Structured Clinical Interview for DSM-IV Axis II Personality Disorders Washington, D.C. American Psychiatric Press
  2. First MB Spitzer RL Gibbon M Williams JBW 2002 Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P) New York Biometrics Research

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Authors
Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. P., & Beck, A.
Affiliations
  • University of Colorado Boulder (US)
  • Emory University (US)
  • West Chester University (US)
  • Kaiser Permanente (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2016-02
Volume
84
Issue
2
Pages
134-145
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000068
PMC
PMC5718345
OpenAlex
W2383797722
Cited by
223
References
61
Citations by year
2026: 18 · 2025: 21 · 2024: 14 · 2023: 32 · 2022: 26 · 2021: 23 · 2020: 26 · 2019: 20 · 2018: 14 · 2017: 20 · 2016: 8 · 2014: 1
FWCI
14.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R34MH083866)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
mindfulness-based cognitive therapy, perinatal depression, depression relapse prevention, postpartum depression, pregnancy, treatment acceptability, usual care, non-pharmacological treatment, mindfulness meditation, cognitive behavioral therapy, maternal mental health
MeSH terms
Adult, Depression, Female, Humans, Pilot Projects, Pregnancy, Recurrence, Cognitive Behavioral Therapy, Treatment Outcome, Depression, Postpartum, Mindfulness

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