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Cited by 41Maternal Mental Health During Pregnancy and PostpartumPersonality Disorders and PsychopathologyMaternal and Perinatal Health Interventions

Public health nurse-delivered group cognitive behavioural therapy for postpartum depression: a randomized controlled trial

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Van Lieshout, Ryan J., Layton, Haley, Savoy, Calan D., Haber, Erika, Feller, Andrea, Biscaro, Anne, Bieling, Peter J., Ferro, Mark A.·2022·The Canadian Journal of Psychiatry
DOI 10.1177/07067437221074426PMC PMC9152236
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Abstract

Objectives: To examine the effectiveness of group cognitive behavioural therapy (CBT) for postpartum depression (PPD) delivered by public health nurses with little to no previous psychiatric training at improving depression, worry, social support and the mother-infant relationship. Methods: Mothers (n = 141) living in Ontario, Canada with Edinburgh Postnatal Depression Scale Scores ≥10 and an infant <12 months of age were randomized to receive nine weekly 2-h sessions of in-person group CBT for PPD delivered by two public health nurses plus treatment as usual (TAU; experimental group) or TAU alone (control group). Primary outcomes were change in EPDS score and current major depressive disorder (Mini International Neuropsychiatric Interview) assessed immediately post-treatment (T2). Secondary outcomes included maternal worry, social support, and quality of the mother-infant relationship. All outcomes were assessed again six months post-treatment (T3). Results: Participants in the experimental group had statistically significantly greater reductions in PPD symptoms immediately post-treatment (T2) (B = -5.35, p < 0.01), were more likely to manifest a clinically significant improvement in EPDS scores (≥4 points; OR = 3.44, 95%CI: 1.49–7.94), and no longer have symptoms consistent with current MDD (OR = 5.31, 95% CI: 1.78–15.83). Six months post-treatment (T3), experimental group participants had higher odds of clinically significant PPD improvement (OR = 5.10, 95%CI: 1.89–13.78), while 25% of the experimental group and 70% of remaining control group participants reported current MDD ( p < 0.01). Statistically significant improvements in worry and the mother-infant relationship were also observed, decreases maintained at six months post-treatment. Conclusions: Public health nurses with little to no previous psychiatric training can be trained to deliver effective group CBT for PPD to improve depression, worry, and the mother-infant relationship. Task shifting PPD treatment with group CBT to public health nurses could improve treatment uptake and lead to better outcomes for mothers, families, and the healthcare system. (Trial Registration NCT03039530)

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  • Participants receiving public health nurse-delivered group CBT were 3.44 times more likely to show a clinically significant EPDS improvement immediately post-treatment.

    “Participants receiving group CBT were 3.44 times more likely to show a clinically significant EPDS improvement immediately post- treatment”

    From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Van Lieshout et al. (2022)

    The Results report that, immediately after treatment, the group-CBT participants had 3.44 times the odds of a clinically significant EPDS reduction (at least 4 points) compared with controls. The claim says “3.44 times more likely,” but 3.44 is an odds ratio, not a ratio of probabilities; the reported proportions were 63.3% versus 33.3%. (LLM, conf=0.88)

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Authors
Van Lieshout, R. J., Layton, H., Savoy, C. D., Haber, E., Feller, A., Biscaro, A., Bieling, P. J., & Ferro, M. A.
Affiliations
  • Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
  • McMaster University (CA)
  • Regional Municipality of Niagara (CA)
  • University of Waterloo (CA)
ORCID
Venue
The Canadian Journal of Psychiatry
Publisher
SAGE Publications
Published
2022-01-21
Volume
67
Issue
6
Pages
432-440
ISSN
  • 0706-7437 (ISSN-L)
  • 1497-0015
DOI
10.1177/07067437221074426
PMC
PMC9152236
OpenAlex
W4206405216
Cited by
41
References
44
Citations by year
2026: 9 · 2025: 10 · 2024: 5 · 2023: 12 · 2022: 5
FWCI
7.06
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The Canadian Journal of Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Physicians' Services Incorporated Foundation (16-49)
  • Hamilton Academic Health Sciences Organization (HAH-16-05)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
postpartum depression, group cognitive behavioral therapy, public health nurses, maternal depression, maternal worry, social support, mother-infant relationship, task shifting, treatment uptake, Edinburgh Postnatal Depression Scale, major depressive disorder
MeSH terms
Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Infant, Ontario, Cognitive Behavioral Therapy, Depression, Postpartum, Nurses, Public Health

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