The effect of physician-based cognitive behavioural therapy among pregnant women with depressive symptomatology: a pilot quasi-experimental trial

Early Interv Psychiatry. 2014 Nov;8(4):348-57. doi: 10.1111/eip.12074. Epub 2013 Jul 15.

Abstract

Objective: The purpose of this pilot study is to evaluate the feasibility of a physician-based cognitive behavioural (CBT) intervention for the treatment of depressive symptomatology among pregnant women.

Methods: A pilot quasi-experimental trial was conducted in a family practice health centre in Toronto, Canada. Pregnant women (n = 42) were identified as having depressive symptomatology according to the Edinburgh Postnatal Depression Scale (EPDS) and allocated to either a control group (standard prenatal) or an intervention group. The intervention group received standard prenatal plus brief CBT, initiated between the 20th and 28th gestation week prenatal visit, from their obstetrical physician. Follow-up assessments were conducted at 38 weeks gestation and 6 weeks post-partum to examine depressive symptomatology, anxiety symptomatology, health-care utilization, medication utilization and overall treatment satisfaction.

Results: The delivery of the CBT intervention was feasible, acceptable and produced relatively high rates of treatment adherence. Of the 21 women in the intervention group who evaluated their CBT experience, 90% were satisfied. Although not sufficiently powered to detect differences between the study groups, trends in the clinical outcome data favoured the intervention group where mean depression and anxiety scores were lower for those who received the brief CBT intervention than those in the control group.

Conclusion: Results suggest that brief physician-based CBT may be a feasible antenatal depression treatment option. The high satisfaction with, and acceptance of, the intervention by study participants and physicians suggests that a larger randomized trial is warranted.

Keywords: anxiety; cognitive behaviour therapy; controlled clinical trial; depression; pregnancy.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / complications
  • Anxiety / diagnosis
  • Cognitive Behavioral Therapy / methods*
  • Depression / complications
  • Depression / diagnosis
  • Depression / therapy*
  • Family Practice / methods*
  • Female
  • Humans
  • Patient Acceptance of Health Care
  • Patient Compliance
  • Patient Satisfaction
  • Pilot Projects
  • Pregnancy
  • Pregnant Women / psychology*
  • Symptom Assessment
  • Young Adult