Cognitive-behavioral therapy (CBT) is an effective treatment for mood and anxiety disorders and has been shown to be effective for the treatment of postpartum depression (PPD). However, not all women have access to CBT-savvy therapists. In addition, it is often difficult for new mothers to travel outside of the home for regular appointments. A recent study demonstrates that CBT delivered via telephone may be a useful and effective intervention for depressed mothers with newborn infants.
This multisite randomized controlled trial was conducted in the obstetric units of 3 regional hospitals in Hong Kong. A total of 397 women with an Edinburgh Postnatal Depression Scale (EPDS) score > 10 on the second or third day postpartum were randomized to receive either telephone-based CBT (n = 197) or standard care (n = 200).
Compared to standard care, telephone-based CBT was associated with significantly lower depressive symptoms when assessed at 6 weeks postpartum in mothers with minor depression (EPDS 10-12; difference = 1.90, 95% CI: 0.72-3.08; p = 0.002) and major depression (EPDS >13; difference = 5.00, 95% CI: 3.12-6.88; p < 0.001). The effect was sustained at 6 months postpartum in the subgroup with minor depression but was not sustained in the subgroup of mothers with major depression.
This study indicates that telephone-based CBT would be an appropriate intervention for women with mild to moderate postpartum depression. While it appears that this form of CBT was initially helpful for women with more severe symptoms, the effects were not sustained. It is not clear if this population may need a longer course of treatment or if this form of telephone-based CBT is not as effective in this subgroup.
Ruta Nonacs, MD PhD
Ngai FW, Wong PW, Leung KY, Chau PH, Chung KF. The Effect of Telephone-Based Cognitive-Behavioral Therapy on Postnatal Depression: A Randomized Controlled Trial. Psychother Psychosom. 2015 Aug 6;84(5):294-303. [Epub ahead of print]