Development and evaluation of a cognitive-behavioral therapeutic intervention program for high-risk pregnant women with perinatal depression and anxiety

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K19162
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58070:Lifelong developmental nursing-related
• Research Institution: The Japanese Red Cross Toyota College of Nursing (2023); National Center of Neurology and Psychiatry (2020-2022)
• Principal Investigator: Okatsu Aiko 日本赤十字豊田看護大学, 看護学部, 准教授 (20736467)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 周産期メンタルヘルス / 認知行動療法 / 産後うつ病 / 周産期うつ / 不安障害 / CBT / 助産師

Outline of Final Research Achievements

This study developed and evaluated a midwife-led cognitive behavioral therapy (CBT) program for the prevention of perinatal depression and anxiety in a pilot randomized controlled trial. Sixty-three pregnant women participated in the study, with a total of three sessions conducted during pregnancy. Results of this study, especially among in primiparas, the intervention group showed a greater change in the degree of anxiety than the control group, with small to moderate effect sizes (T3-T1: d=0.35, T2-T2: d=0.53).
In multiparas, the intervention group showed a decrease in the level of depression and anxiety from pre-intervention to post-intervention and one month postpartum, while the control group showed a tendency for depression and anxiety to decrease after the intervention but to increase again at one month postpartum.
The results of study suggest different trends for primiparas and multiparas, indicating that the intervention is expected to be particularly effective for primiparas.

Free Research Field

周産期メンタルヘルス

Academic Significance and Societal Importance of the Research Achievements

周産期メンタルヘルス支援において、妊娠期・産後の軽度から中等度のうつ症状に対して、また不安症の中等度以下の場合には、認知行動療法に基づくセルフヘルプが推奨されている。しかし、助産師による認知行動療法の実践報告は非常に少なく、日本では厳格な臨床試験による検証は見当たらない。助産師は妊産婦にとって身近な存在であり、妊娠期から産後を通して、定期的に関わることができる機会を持つ。うつ病や不安を呈するハイリスク妊婦に対して、助産師がCBTプログラムを提供することができれば、産後うつ病の発症の予防につながる。