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Keywords:

  • anxiety;
  • cognitive behaviour therapy;
  • controlled clinical trial;
  • depression;
  • pregnancy

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.