Netmums: a phase II randomized controlled trial of a guided Internet behavioural activation treatment for postpartum depression

Abstract

BackgroundDespite the high prevalence of postnatal depression (PND), few women seek help. Internet interventions may overcome many of the barriers to PND treatment use. We report a phase II evaluation of a 12-session, modular, guided Internet behavioural activation (BA) treatment modified to address postnatal-specific concerns [Netmums Helping With Depression (NetmumsHWD)].MethodTo assess feasibility, we measured recruitment and attrition to the trial and examined telephone session support and treatment adherence. We investigated sociodemographic and psychological predictors of treatment adherence. Effectiveness outcomes were estimated with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Postnatal Bonding Questionnaire, and Social Provisions Scale.ResultsA total of 249 women were recruited via a UK parenting site, Netmums.com. A total of 83 women meeting DSM-IV criteria for major depressive disorder were randomized to NetmumsHWD (n = 41) or treatment-as-usual (TAU; n = 42). Of the 83 women, 71 (86%) completed the EPDS at post-treatment, and 71% (59/83) at the 6-month follow-up. Women completed an average of eight out of 12 telephone support sessions and five out of 12 modules. Working women and those with less support completed fewer modules. There was a large effect size favouring women who received NetmumsHWD on depression, work and social impairment, and anxiety scores at post-treatment compared with women in the TAU group, and a large effect size on depression at 6 months post-treatment. There were small effect sizes for postnatal bonding and perceived social support.ConclusionsA supported, modular, Internet BA programme can be feasibly delivered to postpartum women, offering promise to improve depression, anxiety and functioning.

Web‐based integrated bipolar parenting intervention for parents with bipolar disorder: a randomised controlled pilot trial

“…Supported online psychological interventions can improve clinical outcomes in mothers with postnatal depression (Kaplan, Solomon, Salzer, & Brusilovskiy, 2014; O'Mahen et al., 2014) and parenting in parents with and without mental health problems (Love et al., 2016; Sanders, Baker, & Turner, 2012; Sanders, Dittman, Farruggia, & Keown, 2014). Additionally, three studies of online Triple P indicated child behaviour improvements (Love et al., 2016; Sanders et al., 2012; Sanders, Dittman et al., 2014).…”

Computer-Assisted Cognitive Behavioral Therapy for Pregnant Women with Major Depressive Disorder

“…22 Cognitive behavioral therapy (CBT) for AD has been associated with better infant orientation, engagement and emotional regulation in women with improvement in their depression symptoms. 23 CBT has been studied more extensively for postpartum depression, 21 and computer-based interventions for postpartum depression that involved personal coach calls 24 or weekly phone call support 25 significantly improved symptoms. Modified CBT for women with AD has been attempted in two pilot studies.…”

Blended cognitive behavior therapy : efficacy and acceptability for treating depression in the adult and adolescent population

“…ICBT with clinician guidance has been found to be effective for depression and other common mental disorders (e.g., Andersson, Cuijpers, Carlbring, Riper & Hedman, 2014;Cuijpers, Donker, van Straten & Andersson, 2010;Kuester, Niemeyer & Knaevelsrud, 2016: O'Mahen et al, 2014, insomnia (Trockel, Karlin, Taylor & Manber, 2014) as well as a range of somatic conditions (e.g., Andersson, 2016;Cuijpers et al, 2010;Cuijpers, van Straten & Andersson, 2008). In one of the more recent reviews, the overall treatment effect for ICBT for depression, based on 32 trials and 5642 patients, was estimated to g = 0.67 (Andrews et al, 2018).…”