Huibert Burger1, Tjitte Verbeek2, Judith L Aris-Meijer3, Chantal Beijers4, Ben W Mol5, Steven D Hollon6, Johan Ormel7, Mariëlle G van Pampus8, Claudi L H Bockting9. 1. Associate Professor of Clinical Epidemiology, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. 2. Researcher, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. 3. Researcher, Department of Epidemiology, University Medical Centre Groningen, The Netherlands. 4. Researcher, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. 5. Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia. 6. Professor of Psychology, Department of Psychology, Vanderbilt University, Tennessee, USA. 7. Professor of Social Psychiatry and Psychiatric Epidemiology, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. 8. Gynaecologist, Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, The Netherlands. 9. Professor of Clinical Psychology, Department of Psychiatry, Amsterdam University Medical Centre; and Institute for Advanced Study, University of Amsterdam, The Netherlands.
Abstract
BACKGROUND:Perinatal depression and anxiety are associated with unfavourable child outcomes. AIMS: To assess among women with antenatal depression or anxiety the effectiveness of prenatally initiatedcognitive-behavioural therapy (CBT) on mother and child compared with care as usual (CAU). Trial registration: Netherlands Trial Register number NTR2242. METHOD:Pregnant women (n = 282) who screened positive for symptoms of depression and/or anxiety were randomised to either CBT (n = 140) or CAU (n = 142). The primary outcome was child behavioural and emotional problems at age 18 months, assessed using the Child Behavior Checklist (CBCL). Secondary outcomes were maternal symptoms during and up to 18 months after pregnancy, neonatal outcomes, mother-infant bonding and child cognitive and motor development at age 18 months. RESULTS: In total, 94 (67%) women in the CBT group and 98 (69%) in the CAU group completed the study. The mean CBCL Total Problems score was non-significantly higher in the CBT group than in the CAU group (mean difference: 1.38 (95% CI -1.82 to 4.57); t = 0.85, P = 0.399). No effects on secondary outcomes were observed except for depression and anxiety, which were higher in the CBT group than in the CAU group at mid-pregnancy. A post hoc analysis of the 98 women with anxiety disorders showed lower infant gestational age at delivery in the CBT than in the CAU group. CONCLUSIONS: Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety. Our findings are not in line with present recommendations for universal screening and treatment for antenatal depression or anxiety, and future work may include the relevance of baseline help-seeking.
RCT Entities:
BACKGROUND: Perinatal depression and anxiety are associated with unfavourable child outcomes. AIMS: To assess among women with antenatal depression or anxiety the effectiveness of prenatally initiated cognitive-behavioural therapy (CBT) on mother and child compared with care as usual (CAU). Trial registration: Netherlands Trial Register number NTR2242. METHOD: Pregnant women (n = 282) who screened positive for symptoms of depression and/or anxiety were randomised to either CBT (n = 140) or CAU (n = 142). The primary outcome was child behavioural and emotional problems at age 18 months, assessed using the Child Behavior Checklist (CBCL). Secondary outcomes were maternal symptoms during and up to 18 months after pregnancy, neonatal outcomes, mother-infant bonding and child cognitive and motor development at age 18 months. RESULTS: In total, 94 (67%) women in the CBT group and 98 (69%) in the CAU group completed the study. The mean CBCL Total Problems score was non-significantly higher in the CBT group than in the CAU group (mean difference: 1.38 (95% CI -1.82 to 4.57); t = 0.85, P = 0.399). No effects on secondary outcomes were observed except for depression and anxiety, which were higher in the CBT group than in the CAU group at mid-pregnancy. A post hoc analysis of the 98 women with anxiety disorders showed lower infant gestational age at delivery in the CBT than in the CAU group. CONCLUSIONS: Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety. Our findings are not in line with present recommendations for universal screening and treatment for antenatal depression or anxiety, and future work may include the relevance of baseline help-seeking.
Authors: Heather A O'Mahen; Paul G Ramchandani; Sarah L Halligan; Pasco Fearon; Dorothy X King; Leonie Lee-Carbon; Esther L Wilkinson; Chloe Thompson-Booth; Jennifer Ericksen; Jeannette Milgrom; Jacqueline Dunkley-Bent Journal: BMC Psychiatry Date: 2022-02-17 Impact factor: 3.630
Authors: M A M Baas; M G van Pampus; C A I Stramrood; L M Dijksman; J W Vanhommerig; A de Jongh Journal: Front Psychiatry Date: 2022-02-10 Impact factor: 4.157
Authors: Anke B Witteveen; Jens Henrichs; Annika L Walker; Ernst T Bohlmeijer; Huibert Burger; Yvonne Fontein-Kuipers; Francois G Schellevis; Claire A I Stramrood; Miranda Olff; Corine J Verhoeven; Ank de Jonge Journal: BMC Pregnancy Childbirth Date: 2020-11-19 Impact factor: 3.007