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Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder

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Abstract

The perinatal period is a high-risk time for mood deterioration among women vulnerable to depression. This study examined feasibility, acceptability, and improvement associated with mindfulness-based cognitive therapy (MBCT) in perinatal women with major depressive disorder (MDD) or bipolar spectrum disorder (BSD). Following a diagnostic evaluation, 39 perinatal women with a lifetime history of MDD (n = 27) or BSD (n = 12) enrolled in an 8-week program of MBCT classes (2 h each) that incorporated meditation, yoga, and mood regulation strategies. Participants were pregnant (n = 12), planning pregnancy (n = 11), or up to 1-year postpartum (n = 16). Participants were self-referred and most had subthreshold mood symptoms. Assessments of depression, (hypo)mania, and anxiety were obtained by interview and self-report at baseline, post-treatment and at 1- and 6-month post-treatment. Women with a history of MDD were more likely to complete the classes than women with BSD. Of 32 women who completed the classes, 7 (21.9 %) had a major depressive episode during the 6-month post-treatment follow-up. On average, participants with MDD reported improvements in depression from pre- to post-treatment. Mood improvement was not observed in the BSD group. In the full sample, improvements in depression symptoms across time points were associated with increasing mindful tendency scores. This study was limited by its uncontrolled design, heterogeneous sample, and questionnaire-based assessment of mindfulness skills. MBCT may be an important component of care for perinatal women with histories of major depression. Its applicability to perinatal women with BSD is unclear.

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Conflict of Interest

This study was supported by grants from the Danny H. Alberts Foundation and the Attias Family Foundation, and Grant R01-MH093676 from the National Institute of Mental Health (NIMH) (Miklowitz, PI). Author D. Miklowitz lists the following financial relationships: NIMH, Carl and Roberta Deutsch Foundation, Kayne Family Foundation, Knapp Foundation, Danny H. Alberts Foundation, and Attias Family Foundation; and book royalties from Guilford Press and John Wiley and Sons. Author S. Dimidjian receives research funding from the NIMH and book royalties from Guilford Press. Authors R. Semple, D. Elkun, and M. Weintraub have no financial or other relationships that would create a conflict of interest regarding this manuscript.

Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of each institution’s research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants after they received a full explanation of the study procedures. The protocol was reviewed and approved by the Human Subject Review Boards of the University of Colorado and the UCLA School of Medicine.

Animal Rights

No animals studies were carried out by the authors for this paper.

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Authors and Affiliations

  1. Department of Psychiatry, UCLA Semel Institute, David Geffen School of Medicine at UCLA, 760 Westwood Plaza Rm 58-217, Los Angeles, CA, USA

    David J. Miklowitz, Randye J. Semple & Marc J. Weintraub

  2. Department of Psychology, University of Colorado, Boulder, CO, USA

    Monika Hauser, Dana Elkun & Sona Dimidjian

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  1. David J. Miklowitz
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  2. Randye J. Semple
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  3. Monika Hauser
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  4. Dana Elkun
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  6. Sona Dimidjian
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Correspondence to David J. Miklowitz.

Additional information

Clinical Trials Registration: NCT02150681.

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Miklowitz, D.J., Semple, R.J., Hauser, M. et al. Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder. Cogn Ther Res 39, 590–600 (2015). https://doi.org/10.1007/s10608-015-9681-9

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