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The Efficacy of Therapist-Guided Internet-Based Psychotherapy for Treating Mild to Moderate Depression and Anxiety Among Women Hospitalized with High-Risk Pregnancies

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Abstract

Background

Despite ample evidence of high depression rates among women with high-risk pregnancies, there is limited information available regarding the effectiveness of Internet-based psychotherapies in this population. This study aimed to assess the effectiveness of internet-based psychotherapy in treating depression and anxiety in pregnant women with high-risk pregnancies admitted to the hospital.

Methods

In a quasi-experimental study, 60 inpatient women with high-risk pregnancies exhibiting mild to moderate depression were allocated to either the experimental (n = 30) or control (n = 30) group. The experimental group received medical therapy with Internet-based Synchronous Individualized Therapy for six sessions, each lasting 50–60 min, conducted over six weeks. The control group solely received medical therapy. All participants completed questionnaires, including the Brief Symptom Inventory (BSI-18) and Edinburgh Postnatal Depression Scale, at both baseline and the post-trial stage (6 weeks after the study commencement).

Results

The mean scores for depression and anxiety in both groups were elevated (experimental group: M = 11.36, SD = 4.84; M = 13.82, SD = 4.78; control group: M = 11.4, SD = 4.8; M = 13.6, SD = 4.6). Symptom severity decreased more significantly in the group receiving internet psychotherapy in addition to medical treatment than in the control group, with medium effect sizes observed for depression symptoms (η2 = 0.145, P = 0.003) and anxiety symptoms (η2 = 0.238, P < 0.001). Furthermore, the reduction in anxiety and depression scores in the internet psychotherapy group was notably more significant than in the control group, with a moderate effect size (η2 = 0.177, P = 0.041).

Conclusion

Augmenting medical therapy with therapist-guided internet-based psychotherapy may effectively reduce depression, anxiety, and psychological distress in pregnant women experiencing high-risk pregnancies and comorbid depression. These findings suggest that hospitalized, depressed pregnant women with high-risk pregnancies should be offered internet-based psychotherapy as an adjunctive treatment option.

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Acknowledgements

The authors would like to express their gratitude to The National Institute for Medical Research Development (NIMAD) for supporting the funding (Grant Number: 973413). The funder reviewed the project plan and rewarded a small grant for implementation of the project. The Ethical Committee of the National Institute for Medical Research Development (NIMAD) approved the study (IR.NIMAD.REC.1398.015). Also, we would like to thank Noushin Fatri for helping us to invite the patients

Funding

This study was supported by the. National Institute for Medical Research Development (NIMAD) Grant No. 973413.

Author information

Authors and Affiliations

  1. Behshahr Azad University, Behshahr, Islamic Republic of Iran

    Shirin Shahrokhi (MsC Student)

  2. Department of Obstetrics and Gynecology, School of Medicine, Infertility and Reproductive Health Research Center, Health Research Institute Rouhani Hospital, Fatima Al-Zahra Research Center for Fertility and Infertility, Babol University of Medical Sciences, Babol, Islamic Republic of Iran

    Zahra Basirat (Professor)

  3. Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Department of Obstetrics and Gynecology, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran

    Shahnaz Barat (Associate Professor)

  4. Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Department of Psychiatry, Babol University of Medical Sciences, Babol, Islamic Republic of Iran

    Farzan Kheirkhah (Professor)

  5. Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA

    Elizabeth O’Connor (Investigator)

  6. Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran

    Seyyedeh Mahboubeh Mirtabar (PhD candidate)

  7. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran

    Hemmat Gholinia

  8. Psychology, Population, Family and Spiritual Health Research Center, Health Research Institute, Department of General Courses, Babol University of Medical Sciences, Babol, Islamic Republic of Iran

    Mahbobeh Faramarzi (Professor)

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  1. Shirin Shahrokhi
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  8. Mahbobeh Faramarzi
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Corresponding author

Correspondence to Mahbobeh Faramarzi.

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The author declares no conflict of interest.

Ethical Approval

This project was approved by Ethic Committee of National Institute for Medical Research Development (NIMAD) (IR.NIMAD.REC.1398.015).

Informed Consent

Informed written consent was obtained from each participant before participating in the study. Anonymity and confidentiality for participants were guaranteed. All methods were carried out in accordance with Declaration of Helsinki guidelines and regulations.

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Shirin Shahrokhi is a MsC Student; Zahra Basirat is a Professor; Shahnaz Barat is a Associate Professor; Farzan Kheirkhah is a Professor; Elizabeth O’Connor is a Investigator; Seyyedeh Mahboubeh Mirtabar is a PhD candidate; Mahbobeh Faramarzi is a Professor.

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Shahrokhi, S., Basirat, Z., Barat, S. et al. The Efficacy of Therapist-Guided Internet-Based Psychotherapy for Treating Mild to Moderate Depression and Anxiety Among Women Hospitalized with High-Risk Pregnancies. J Obstet Gynecol India (2024). https://doi.org/10.1007/s13224-024-01946-0

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