Internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period
Internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period
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DOI：
10.1192/j.eurpsy.2023.394
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发表时间：
2023-07-19
影响因子：
7.8
通讯作者：
Kawakami, N.
中科院分区：
文献类型：
--
作者：
Nishi, D.;Imamura, K.;Watanabe, K.;Obikane, E.;Sasaki, N.;Yasuma, N.;Sekiya, Y.;Matsuyama, Y.;Kawakami, N.
从产前开始预防围产期抑郁症至关重要。本研究旨在调查最近开发的互联网认知行为疗法 (iCBT) 对于预防妊娠晚期和产后 3 个月重度抑郁发作 (MDE) 的有效性。这是一项双臂、平行组、一般信息对照、随机对照试验。参与者是 5,017 名怀孕 16-20 周的孕妇，基线时没有 MDE。他们被随机分配到 iCBT（干预组；n = 2,509）或一般信息组（对照组；n = 2,508），并根据基线时的心理困扰进行分层。主要结果是妊娠 32 周和产后 3 个月时新发 MDE 的数量，使用世界卫生组织综合国际诊断访谈 3.0 进行测量。随访期间，干预组有 59 名参与者（2.35%）报告新发 MDE，对照组有 73 名参与者（2.91%）报告新发 MDE。与对照组相比，干预组发生MDE的风险比（HR）为0.85（95% CI 0.61-1.20）。在基线 K6 得分为 5 至 8 分的参与者中，干预组有 10 名（1.37%）报告新发 MDE，而对照组有 28 名（3.81%），MDE 的 HR 为 0.38（95%CI 0.19-0.79）。没有发现 iCBT 在预防新发围产期 MDE 方面有干预作用。 iCBT 仅可能预防有阈下抑郁症状的孕妇的围产期抑郁症。未声明
Prevention of perinatal depression beginning from the antenatal period is essential. 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. This is a two-arm, parallel-group, general-information controlled, randomized controlled trial. Participants were 5,017 pregnant women at 16–20 weeks’ gestation without MDE at baseline. They were randomly assigned to an iCBT (intervention; n = 2,509) or general-information (control; n = 2,508) 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. 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). 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). 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. None Declared