期刊
JOURNAL OF AFFECTIVE DISORDERS
卷 150, 期 3, 页码 814-822出版社
ELSEVIER
DOI: 10.1016/j.jad.2013.03.005
关键词
Postnatal depression; Cognitive behavioral therapy; Behavioral activation; Online cbt; Depression; Randomized controlled trial
资金
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care
- National Institute for Health Research [NF-SI-0611-10203] Funding Source: researchfish
Background: Despite the high prevalence of postnatal depression (PND), few women seek help. The interact may increase timely access to treatment. We report a randomized controlled trial of a minimal intervention internet Behavioral Activation (iBA) treatment modified to address postnatal specific concerns (Postnatal-iBA). Methods: Women (n=910) recruited via a popular UK parenting site, Netmums.corn, scoring above 12 on the Edinburgh Postnatal Depression Scale (EPDS) were randomly assigned to receive either Postnatal BA delivered or treatment-as-usual (TAU). We investigated the feasibility (recruitment, trial and treatment adherence) and effectiveness (depression status EPDS > 12) of the intervention. Results: Recruitment was excellent; 1261 women, 961 of whom met inclusion criteria, signed up to the trial within two 2-week recruitment periods. Thirty-eight percent (343/910) of women completed the 15 week outcome assessment. Of those who completed 15 week assessment, fewer exceeded the depression cutoff in the Postnatal-iBA group (n=66/181) compared to TAU (n=91/162). Assuming all non respondents remained depressed, the Postnatal-iBA effect was reduced. Limitations: The study suffered from high attrition and future trials need to consider strategies for improving outcome completion. Some women reported struggles keeping up with the treatment. Conclusions: A minimal support, widely accessible internet Behavioral Activation program for END is feasible to deliver to community populations when embedded within popular parenting sites. For women who provide outcome data, postnatal-iBA offers promise as an effective treatment for END. The addition of support may reduce women's struggles to keep pace with the treatment. (C) 2013 Elsevier B.V. All rights reserved.
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