A pilot randomised controlled trial of cognitive behavioural therapy for antenatal depression

BMC Psychiatry

Jonathan Evans⁴  Sian Noble³  Joanna Thorn³  Debbie Sharp¹  Katrina Turner¹  Paul Ramchandani⁵  Nicola Wiles⁴  Kristina Bennert⁴  Helen Baxter⁴  Heather O’Mahen²  Alison Burns⁴ 

[1] Centre for Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK;Department of Mood Disorder, University of Exeter, Exeter EX4 4QG, UK;School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK;Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN, UK;Academic Unit of Child and Adolescent Psychiatry, Imperial College, London W2 1PG, UK

关键词: Pregnancy;    Cognitive behavioural therapy;    Antenatal depression;    Randomised controlled trial;   

Others  :  1124160
DOI  :  10.1186/1471-244X-13-33

 received in 2012-09-05, accepted in 2013-01-14,  发布年份 2013

【 摘 要 】

Background

Few trials have evaluated the effectiveness of psychological treatment in improving depression by the end of pregnancy. This is the first pilot randomised controlled trial (RCT) of individual cognitive behavioural therapy (CBT) looking at treating depression by the end of pregnancy. Our aim was to assess the feasibility of delivering a CBT intervention modified for antenatal depression during pregnancy.

Methods

Women in North Bristol, UK between 8–18 weeks pregnant were recruited through routine contact with midwives and randomised to receive up to 12 sessions of individual CBT in addition to usual care or to continue with usual care only. Women were eligible for randomisation if they screened positive on a 3-question depression screen used routinely by midwives and met ICD-10 criteria for depression assessed using the clinical interview schedule – revised version (CIS-R). Two CBT therapists delivered the intervention. Follow-up was at 15 and 33 weeks post-randomisation when assessments of mental health were made using measures which included the CIS-R.

Results

Of the 50 women assessed for the trial, 36 met ICD-10 depression criteria and were randomised: 18 to the intervention and 18 to usual care. Thirteen of the 18 (72%) women who were allocated to receive the intervention completed 9 or more sessions of CBT before the end of pregnancy. Follow-up rates at 15 and 33 weeks post-randomisation were higher in the group who received the intervention (89% vs. 72% at 15 weeks and 89% vs. 61% at 33 weeks post-randomisation). At 15 weeks post-randomisation (the end of pregnancy), there were more women in the intervention group (11/16; 68.7%) who recovered (i.e. no longer met ICD-10 criteria for depression), than those receiving only usual care (5/13; 38.5%).

Conclusions

This pilot trial shows the feasibility of conducting a large RCT to assess the effectiveness of CBT for treating antenatal depression before the end of pregnancy. The intervention could be delivered during the antenatal period and there was some evidence to suggest that it could be effective.

Trial registration

ISRCTN44902048

【 授权许可】

   
2013Burns et al.; licensee Biomed Central Ltd.

【 图 表 】

Figure 1.

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