Carona Carlos, Pereira Marco, Araújo-Pedrosa Anabela, Canavarro Maria Cristina, Fonseca Ana
Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra, Coimbra, Portugal.
Obstetrics Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
JMIR Ment Health. 2023 Mar 17;10:e39253. doi: 10.2196/39253.
Postpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the use of web-based intervention programs.
The objective of this study was 2-fold: first, to assess the efficacy of Be a Mom, a brief web-based selective or indicated preventive intervention, in reducing depressive and anxiety symptoms of women at high risk for PPD; and second, to examine mechanisms of change linking modifiable self-regulatory skills (ie, emotion regulation, self-compassion, and psychological flexibility) to improved perinatal mental health outcomes.
This 2-arm, open-label randomized controlled trial involved a sample of 1053 perinatal women presenting high risk for PPD who were allocated to the Be a Mom intervention group or a waitlist control group and completed self-report measures at baseline and postintervention assessments. Univariate latent change score models were computed to determine changes over time in adjustment processes and outcomes, with a multigroup-model approach to detect differences between the intervention and control groups and a 2-wave latent change score model to examine whether changes in processes were related to changes in outcomes.
Be a Mom was found to be effective in reducing depressive (intervention group: µΔ=-3.35; P<.001 vs control group: µΔ=-1.48; P<.001) and anxiety symptoms (intervention group: µΔ=-2.24; P<.001 vs control group: µΔ=-0.43; P=.04) in comparison with the control group, where such changes were inexistent or much smaller. All 3 psychological processes under study improved statistically significantly in posttreatment assessments: emotion regulation ability (Δχ=12.3; P=.007) and psychological flexibility (Δχ=34.9; P<.001) improved only in the intervention group, and although self-compassion increased in both groups (Δχ=65.6; P<.001), these improvements were considerably greater in the intervention group.
These results suggest that Be a Mom, a low-intensity cognitive behavioral therapy program, is a promising first-line intervention for helping perinatal women, particularly those with early-onset PPD symptoms.
ClinicalTrials.gov NCT03024645; https://clinicaltrials.gov/ct2/show/NCT03024645.
产后抑郁症（PPD）是可治疗和可预防的，但大多数女性在围产期出现抑郁症状时并未寻求专业帮助。一种越来越流行的改善就医途径的方法是使用基于网络的干预项目。
本研究的目的有两个：第一，评估“成为妈妈”这一基于网络的简短选择性或指导性预防干预措施在减轻PPD高危女性抑郁和焦虑症状方面的疗效；第二，研究将可改变的自我调节技能（即情绪调节、自我同情和心理灵活性）与改善围产期心理健康结果相联系的变化机制。
这项双臂、开放标签的随机对照试验纳入了1053名PPD高危围产期女性样本，她们被分配到“成为妈妈”干预组或等待名单对照组，并在基线和干预后评估时完成自我报告测量。计算单变量潜在变化分数模型以确定调整过程和结果随时间的变化，采用多组模型方法检测干预组和对照组之间的差异，并采用两波潜在变化分数模型检查过程变化是否与结果变化相关。
与对照组相比，发现“成为妈妈”在减轻抑郁（干预组：μΔ=-3.35；P<.001，对照组：μΔ=-1.48；P<.001）和焦虑症状（干预组：μΔ=-2.24；P<.001，对照组：μΔ=-0.43；P=.04）方面有效，而对照组中此类变化不存在或小得多。在治疗后评估中，所有3种研究的心理过程均有统计学显著改善：情绪调节能力（Δχ=12.3；P=.007）和心理灵活性（Δχ=34.9；P<.001）仅在干预组中有所改善，虽然两组的自我同情都有所增加（Δχ=65.6；P<.001），但干预组的这些改善要大得多。
这些结果表明，“成为妈妈”这一低强度认知行为治疗项目是帮助围产期女性，尤其是那些有早发性PPD症状女性的有前景的一线干预措施。
ClinicalTrials.gov NCT03024645；https://clinicaltrials.gov/ct2/show/NCT03024645 。
