Abstract
BACKGROUND: Up to one in eight women experience depression during pregnancy. In the UK, low intensity cognitive behavioural therapy (CBT) is the main psychological treatment offered for those with mild or moderate depression and is recommended during the perinatal period, however referral by midwives and take up of treatment by pregnant women is extremely low. Interpersonal Counselling (IPC) is a brief, low-intensity form of Interpersonal Psychotherapy (IPT) that focuses on areas of concern to service users during pregnancy. To improve psychological treatment for depression during pregnancy, the study aimed to assess the feasibility and acceptability of a trial of IPC for antenatal depression in routine NHS services compared to low intensity perinatal specific CBT.
METHODS: We conducted a small randomised controlled trial in two centres. A total of 52 pregnant women with mild or moderate depression were randomised to receive 6 sessions of IPC or perinatal specific CBT. Treatment was provided by 12 junior mental health workers (jMHW). The primary outcome was the number of women recruited to the point of randomisation. Secondary outcomes included maternal mood, couple functioning, attachment, functioning, treatment adherence, and participant and staff acceptability.
RESULTS: The study was feasible and acceptable. Recruitment was successful through scanning clinics, only 6 of the 52 women were recruited through midwives. 71% of women in IPC completed treatment. Women reported IPC was acceptable, and supervisors reported high treatment competence in IPC arm by jMHWs. Outcome measures indicated there was improvement in mood in both groups (Change in EPDS score IPC 4.4 (s.d. 5.1) and CBT 4.0 (s.d. 4.8).
CONCLUSIONS: This was a feasibility study and was not large enough to detect important differences between IPC and perinatal specific CBT. A full-scale trial of IPC for antenatal depression in routine IAPT services is feasible.
TRIAL REGISTRATION: This study has been registered with ISRCTN registry 11513120 . - date of registration 05/04/2018.
| Original language | English |
|---|---|
| Article number | 504 |
| Pages (from-to) | 504 |
| Journal | BMC Psychiatry |
| Volume | 21 |
| Issue number | 1 |
| Early online date | 15 Oct 2021 |
| DOIs | |
| Publication status | Published - Dec 2021 |
Bibliographical note
Funding Information:This work was supported by the NIHR under its Research for Patient Benefit Program. The funding body had no role in study design, collection, analysis, and interpretation of data or writing the manuscript. Further support was received from maternity services in acute trusts, mental health trusts and the Clinical Research Network.
Funding Information:
The views expressed by the authors do not necessarily reflect those of the National Institute for Health Research (NIHR), the National Health Service (NHS), or the Department of Health in England. We thank the service users who participated in the study and those individuals who took part in current trial.
Publisher Copyright:
© 2021, The Author(s).
Research Groups and Themes
- HEHP@Bristol
Keywords
- Cognitive Behavioral Therapy
- Counseling
- Depression/therapy
- Depressive Disorder/therapy
- Female
- Humans
- Pregnancy
- Treatment Outcome
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This is the final published version of the article (version of record). It first appeared online via BMC at https://doi.org/10.1186/s12888-021-03482-x . Please refer to any applicable terms of use of the publisher.