An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence
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Pregnant women with histories of depression are at high risk of depressive relapse/recurrence during the perinatal period, and options for relapse/recurrence prevention are limited. Mindfulness-based cognitive therapy (MBCT) has strong evidence among general populations but has not been studied among at-risk pregnant women to prevent depression. We examined the feasibility, acceptability, and clinical outcomes of depression symptom severity and relapse/recurrence associated with MBCT adapted for perinatal women (MBCT-PD). Pregnant women with depression histories were recruited from obstetrics clinics in a large health maintenance organization at two sites and enrolled in MBCT-PD (N = 49). Self-reported depressive symptoms and interview-based assessments of depression relapse/recurrence status were measured at baseline, during MBCT-PD, and through 6-months postpartum. Pregnant women reported interest, engagement, and satisfaction with the program. Retention rates were high, as were rates of completion of daily homework practices. Intent to treat analyses indicated a significant improvement in depression symptom levels and an 18 % rate of relapse/recurrence through 6 months postpartum. MBCT-PD shows promise as an acceptable, feasible, and clinically beneficial brief psychosocial prevention option for pregnant women with histories of depression. Randomized controlled trials are needed to examine the efficacy of MBCT-PD for the prevention of depressive relapse/recurrence during pregnancy and postpartum.
KeywordsPregnancy Depression Prevention Mindfulness Cognitive behavioral therapy
We acknowledge funding by the National Institute of Mental Health (R34MH083866). The authors wish to thank all the study team members who contributed to the completion of this research including our key collaborators at KP (Thomas B. Landry, Deborah Hoerter, Fonda Mitchell, Carolee Nimmer), study therapists (Amy Brooks-DeWeese, Robbin Ryan, Joanne Whalen), research coordinators (Amanda Whittaker, Courtney Timms, Allen Mallory, Christina Metcalf, Abigail Lindemann, Abigail Lockhart), assessors (Debra Boeldt, Christopher Hawkey, Cara Lusby, Meaghan McCallum, Matthew Rouse, Courtney Stevens), and research assistants (Tess Atteberry, Kathryn Breazeale, Lucas Bermudez, Michaela Cuneo, Elizabeth Eustis, Anna Frye, Dhwani Kothari, Nicholas Webb, Jennalee Wooldridge, Nassim Zanganeh, and Capella Zhuang). We would like to express special appreciation for Sharon Salzberg who collaborated on the writing and recording of the meditation instructions, Nancy Bardacke who contributed consultation and the “Being with Baby” meditation practice, De West who recorded the yoga DVD, and Zindel Segal. We also express our gratitude to the members of our Data Safety and Monitoring Board who contributed time and expertise to the oversight of the study.
Conflicts of interest
The authors declare that they have no conflict of interest.
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