Brief, easily accessible, group interventions have the potential to improve postpartum depression care. Such interventions may be particularly useful during the COVID-19 pandemic, which has created new barriers to treatment. A randomized controlled trial was designed to determine whether an online, one-day workshop based on cognitive behavioral therapy plus treatment as usual could improve postpartum depression and its comorbidities compared with treatment as usual alone.

The women participating in this study were either self-referred or referred by health care professionals. Eligible participants were ages 18 or older, had an infant younger than 12 months, and had a score of 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS). A total of 403 women were randomized to receive either the workshop plus treatment as usual (experimental group) or treatment as usual and be put on a waitlist to complete the workshop 12 weeks later (control group). Workshops were conducted online by a registered psychotherapist, a clinical psychology graduate student, or a psychiatrist.

Mean EPDS scores in the experimental group decreased from 16.47 at baseline to 11.65 after the intervention. The researchers note that these results indicate greater odds of exhibiting a clinically significant decrease in scores compared with the control group. Mean scores on the General Anxiety Disorder Questionnaire decreased from 12.41 to 7.97 in the experimental group, and these participants also had greater odds of a clinically significant improvement. Scores on measures of bonding, infant-focused anxiety, social support, and positive affect or surgency in infants also improved after the workshop. The changes were consistent across therapist type.

Study participants were mainly married White women who had free access to universal health care, so the results may not be generalizable to other settings. The authors also note that some participants may not have met diagnostic criteria for major depressive disorder or may have had another mental disorder. Furthermore, outcomes weren't reported until 12 weeks after the workshop, and structured diagnostic interviews weren't used.

Van Lieshout RJ, et al JAMA Psychiatry 2021;78(11):1200-7.