Effect of Acceptance and Commitment Therapy (ACT) on Anxiety and Quality of Life During Pregnancy: A Mental Health Clinical Trial Study

Vakilian, Katayon; Zarei, Fahimeh; Majidi, Abed

doi:10.5812/ircmj.89489

Cited by 15 publications

(20 citation statements)

References 38 publications

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“…The present review is, as far as we know, the first to collect noninvasive interventions that could reduce FoC, not only directly, but also through its factors. Findings indicate that interventions such as birth education (especially employing role‐playing) (Navaee & Abedian, 2015), counseling (Andaroon et al, 2017; Vakilian et al, 2019), and self‐hypnosis (Downe et al, 2015) might be effective to reduce FoC directly; that is in line with previous reviews (Badaoui et al, 2019; Hosseini et al, 2018; Stoll et al, 2017). Nevertheless, in one study it was also found that prenatal education, fulfilled as part of TAU, achieved a lesser reduction of FoC than self‐hypnosis (Downe et al, 2015), what could be attributed to the fact that the education, differing from that used by Navaee and Abedian (2015), was not standardized.…”

Section: Discussionsupporting

confidence: 81%

“…Fear decreased significantly more in the experimental group after the intervention and 24 h after birth. Another study used a counseling intervention based on acceptance and commitment therapy (ACT) and directed it to PrA (Vakilian et al, 2019). In this case, FoC (also studied) was significantly more reduced in the intervention group immediately after the intervention and 1 month later.…”

Section: Resultsmentioning

confidence: 99%

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Psychological, educational, and alternative interventions for reducing fear of childbirth in pregnant women: A systematic review

et al. 2020

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Objective This review aims to identify non‐medical interventions that may reduce the fear of childbirth, directly or indirectly (through its factors). Methods This review followed the PRISMA guidance and a rigorous protocol that was registered in PROSPERO. Searches were done in ProQuest, the International Clinical Trials Registry Platform, and Google Scholar. All RCTs published in the last 5 years, in English or Spanish, regarding women with a low‐risk pregnancy and without mental disorders were included. Results From 5147 articles found, only 69 were full‐text assessed. Finally, 18 studies were included suggesting that prenatal education, psychoeducation, and counseling might be effective, whereas cognitive‐behavioral therapy and some alternative therapies require more research. The results of relaxation techniques were contradictory. Results also suggest that social support and exposure (through education) might have an important role in the efficacy of interventions. Conclusions More appropriately randomized and blinded trials are necessary that use a prespecified definition of fear of childbirth and comprehensive measurement tools specific for pregnant women.

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Section: Discussionsupporting

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Psychological, educational, and alternative interventions for reducing fear of childbirth in pregnant women: A systematic review

et al. 2020

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“…Five studies were cluster RCTs ( 73 , 78 – 81 ) with group assignment at the level of the healthcare center, two were classified as quasi-cluster RCTs ( 75 , 76 ), and thirteen were individual RCTs ( 62 – 72 , 74 , 77 ).…”

Section: Resultsmentioning

confidence: 99%

“…More than half of the studies focused on illness prevention rather than treatment of women with active diagnoses or positive screening for depression or anxiety. Three studies specifically excluded women with elevated Edinburgh Postnatal Depression Screening (EPDS) scores (≥10, >12, and ≥15) ( 66 , 69 , 71 ) and two excluded women with any history of psychiatric disorders ( 63 , 74 ). Of the 20 studies, three focused on women at risk for depression as determined by depression screening tools ( 64 , 65 , 77 ) and five focused on women with depression confirmed by MINI (Mini-International Neuropsychiatric Interview), CIDI (Composite International Diagnostic Interview), or SCID (Structured Clinical Interview for DSM-IV) ( 62 , 70 , 72 , 78 , 79 ).…”

Section: Resultsmentioning

confidence: 99%

“…Interventions were variable across studies. The intervention designs included adapted psychotherapies (40%) ( 63 , 66 , 68 , 70 , 72 , 74 , 79 , 81 ), psychoeducation (20%) ( 65 , 76 , 77 , 80 ), adjuvant emotion/stress management techniques (20%) (mindfulness, relaxation, and exercise) ( 64 , 67 , 69 , 71 , 72 ), stepped care (10%) ( 73 , 78 ), and a multicomponent intervention (5%) (psychoeducation, pharmacotherapy, and non-specialist training) ( 62 ), and psychosocial support (5%) ( 75 ) ( Figure 2 ). Four studies included pharmacotherapy as part of the intervention ( 62 , 73 , 76 , 78 ).…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries

et al. 2022

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BackgroundWomen in low- and middle-income countries (LMICs) are disproportionally affected by perinatal depression and anxiety and lack access to mental health care. Integrating perinatal mental health care into routine maternal care is recommended to address gaps in access to mental health care in such under-resourced settings. Understanding the effectiveness of interventions that integrate perinatal mental health care into routine maternal care in LMICs is critical to inform ongoing intervention development, implementation, and scale-up. This systematic review aims to assess the effectiveness of interventions that integrate perinatal mental health care into routine maternal care to improve maternal mental health and infant health outcomes in LMICs.MethodIn accordance with the PRISMA guidelines, an electronic database search was conducted seeking publications of controlled trials examining interventions that aimed to integrate perinatal mental health care into routine maternal care in LMICs. Abstracts and full text articles were independently reviewed by two authors for inclusion utilizing Covidence Review Software. Data was extracted and narrative synthesis was conducted.FindingsTwenty studies met eligibility criteria from the initial search results of 2,382 unique citations. There was substantial heterogeneity between the study samples, intervention designs, and outcome assessments. Less than half of the studies focused on women with active depression or anxiety. Most studies (85%) implemented single intervention designs involving psychological, psychosocial, psychoeducational, or adjuvant emotion/stress management. There were few interventions utilizing multicomponent approaches, pharmacotherapy, or referral to mental health specialists. Outcome measures and assessment timing were highly variable. Eighteen studies demonstrated significantly greater improvement on depression and/or anxiety measures in the intervention group(s) as compared to control.ConclusionIntegrated interventions can be effective in LMICs. The findings provide a critical understanding of current interventions design gaps. This includes the lack of comprehensive intervention designs that incorporate increasing intensity of treatment for more severe illness, pharmacotherapy, mental health specialist referrals, and non-mental health professional training and supervision. The findings also provide strategies to overcome design and implementation barriers in LMICs. Study findings provide a foundation for future evidence-based adaptation, implementation, and scale-up of interventions that integrate perinatal mental health care into routine maternal care in LMICs.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_ record.php?ID=CRD42021259092], identifier [CRD42021259092].

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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Effect of Acceptance and Commitment Therapy (ACT) on Anxiety and Quality of Life During Pregnancy: A Mental Health Clinical Trial Study

Cited by 15 publications

References 38 publications

Psychological, educational, and alternative interventions for reducing fear of childbirth in pregnant women: A systematic review

Psychological, educational, and alternative interventions for reducing fear of childbirth in pregnant women: A systematic review

A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

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