Internet-based cognitive behavioural therapy (iCBT) for perinatal anxiety and depression versus treatment as usual: study protocol for two randomised controlled trials

Trials. 2018 Jan 22;19(1):56. doi: 10.1186/s13063-017-2422-5.

Abstract

Background: We aimed to evaluate the acceptability and efficacy of two brief, Internet-delivered cognitive behavioural therapy interventions-MUMentum Pregnancy (study 1) and MUMentum Postnatal (study 2)-in reducing maternal symptoms of anxiety, depression and overall psychological distress compared to usual care in the perinatal period.

Methods/design: Women who are pregnant (study 1) or < 12 months postpartum (study 2) with current clinically elevated symptoms of anxiety and/or depression according to validated self-report measures, will be recruited via the research arm of a not-for-profit clinical and research unit in Australia and randomised to the intervention group or treatment as usual control group. The minimum sample size for each study (alpha 0.05; power 0.80 for a g of 0.80) was identified as 50 with at least 10% more to be recruited to account for expected attrition. The co-primary outcome measures are the Patient Health Questionnaire 9-item scale and Generalised Anxiety Disorder 7-item scale to measure depression and anxiety symptom severity, respectively, and will be administered at the following primary time-points: baseline; post treatment; and at one-month follow-up. Psychological distress will be measured according to the Kessler-10 psychological distress scale at each primary time-point and will also be completed before each lesson for those in the intervention group. The total trial period nine weeks for study 1 and 11 weeks for study 2. Program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at one-month follow-up.

Discussion: The current randomised controlled trial seeks to extend the literature by evaluating the efficacy of a self-help intervention for women in the perinatal period. If efficacious, the MUMentum programs have the potential to be easily disseminated via https://thiswayup.org.au/ to large numbers of women across Australia as an intervention for women screening positive for anxiety, depressive or distress symptoms during pregnancy or postpartum.

Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12616000560493 ; ACTRN12616000559415 . Registered on 2nd May 2016.

Keywords: Antenatal; Anxiety; Cognitive behavioural therapy; Depression; Internet; Online; Perinatal; Postpartum; Pregnancy; Treatment.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / psychology
  • Anxiety / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Depression, Postpartum / diagnosis
  • Depression, Postpartum / psychology
  • Depression, Postpartum / therapy*
  • Female
  • Humans
  • Internet*
  • Mental Health
  • New South Wales
  • Patient Health Questionnaire
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy*
  • Therapy, Computer-Assisted / methods*
  • Time Factors
  • Treatment Outcome