1. Effects of psychological treatment of mental health problems in pregnant women to protect their offspring: Randomised controlled trial
- Author
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Mariëlle G. van Pampus, Chantal Beijers, Judith L Aris-Meijer, Steven D. Hollon, Ben W.J. Mol, Huibert Burger, Claudi L H Bockting, Tjitte Verbeek, Johan Ormel, Life Course Epidemiology (LCE), Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Reproductive Origins of Adult Health and Disease (ROAHD), Adult Psychiatry, ANS - Mood, Anxiety, Psychosis, Stress & Sleep, APH - Mental Health, APH - Personalized Medicine, and APH - Digital Health
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,DISORDERS ,CBCL ,Cognitive behavioural therapy ,law.invention ,Randomized controlled trial ,law ,Humans ,Medicine ,DEPRESSION TREATMENT ,Treatment Failure ,Child Behavior Checklist ,Depression (differential diagnoses) ,Netherlands ,child development ,Depressive Disorder ,Cognitive Behavioral Therapy ,business.industry ,PRIMARY-CARE ,Infant ,CHILD-DEVELOPMENT ,medicine.disease ,POSTPARTUM ,anxiety ,Anxiety Disorders ,Child development ,Pregnancy Complications ,Psychiatry and Mental health ,Prenatal Exposure Delayed Effects ,depression ,Antenatal depression ,Anxiety ,Female ,pregnancy ,medicine.symptom ,business ,Perinatal Depression - Abstract
BackgroundPerinatal depression and anxiety are associated with unfavourable child outcomes.AimsTo 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.MethodPregnant 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.ResultsIn 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. Apost hocanalysis of the 98 women with anxiety disorders showed lower infant gestational age at delivery in the CBT than in the CAU group.ConclusionsPrenatally 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.
- Published
- 2020