The preventive effect of internet‐based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period (iPDP): a large scale randomized controlled trial
Open accessAbstract
BACKGROUND: Prevention of perinatal depression beginning from the antenatal period is essential. Therefore, 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 5017 pregnant women at 16-20 weeks' gestation without MDE at baseline. They were randomly assigned to an iCBT (intervention; n = 2509) or general-information (control; n = 2508) 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), which was not significantly different. 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. TRIAL REGISTRATION: UMIN000038190.
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Studies on universal prevention of peripartum depression have produced both no effects and significant effects.
“while studies on universal prevention of peripartum depression have produced both no effects and significant effects (Barrera et al., 2015; Haga et al., 2019; Nishi et al., 2022).”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Nishi et al., 2022
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Research Progress on Screening and Treatment of Perinatal Depression
税, 浩. (2026) · Advances in Clinical Medicine · doi:10.12677/acm.2026.1652103
Advances in Perinatal Depression: A Focus on Screening and Treatment
Shui, H., Cao, X., & 张雪梅 (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15124465
“While not all trials have shown preventive effects, Nishi et al. [145] found no preventive effect of iCBT on the onset of perinatal Major Depressive Episodes (MDE), they suggested that iCBT may still confer benefits in preventing perinatal depression among pregnant individuals with subthreshold…”
Xie, Y., Duan, S., Liu, Y., Shams, M., Yang, J., & Kan, B. (2026) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2026.2689402
Shi, Y., Lau, Y., Chan, S. L., Zhou, L., Au, M. Y. J., & Leung, H. K. (2026) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2026.105650
Wang, L., Yuan, J., & Lei, F. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122336
Wan, Z., Liu, Y., Su, Z., Bai, C., Liu, X., Li, X., Zhao, X., Li, P., Song, L., & Rao, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1896124
“These interventions have been delivered as standardized modules to special groups such as pregnant women through network platforms (such as the Luna Luna Baby application) for the management of negative emotional states (40, 41).”
Elisa, E., Budiono, I., Sriningsih, I., & Wati, C. R. (2026) · BIO Web of Conferences · doi:10.1051/bioconf/202624704003
- Authors
- Nishi, D., Imamura, K., Watanabe, K., Obikane, E., Sasaki, N., Yasuma, N., Sekiya, Y., Matsuyama, Y., & Kawakami, N.
- Affiliations
- National Center of Neurology and Psychiatry (JP)
- The University of Tokyo (JP)
- Kitasato University (JP)
- Ageonomori Clinic Ageo Saitama Japan
- Corresponding author
- Nishi, Daisuke
- ORCID
- Venue
- Psychiatry and Clinical Neurosciences
- Publisher
- Wiley
- Published
- 2022-09-16
- Volume
- 76
- Issue
- 11
- Pages
- 570-578
- ISSN
- 1323-1316 (ISSN-L)
- 1440-1819
- PMC
- PMC9826475
- OpenAlex
- W4296163635
- Cited by
- 45
- References
- 33
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 10 · 2023: 6 · 2022: 1
- FWCI
- 7.51
- Type
- journal article
- Language
- en
- Update notices
- erratum (2023-03-28)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychiatry and Clinical Neurosciences (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (19H01073)
- 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
- internet-based cognitive behavioral therapy, perinatal depression, depression prevention, major depressive episode, pregnancy, postpartum period, third trimester, subthreshold depression, psychological distress, Kessler K6
- MeSH terms
- Depression, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Pregnancy, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Postpartum Period
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