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Treatment - CBT

Cognitive behavioural therapy versus psychoeducation for perinatal anxiety: Preliminary pre-post and follow-up outcomes from a randomized controlled trial

(PS12-A20) Cognitive Behavioural Therapy versus Psychoeducation for Perinatal Anxiety: Preliminary Pre-post and Follow-up Outcomes from a Randomized Controlled Trial

Saturday, November 18, 2023
4:00 PM – 5:00 PM PST
Location: Regency Ballroom, Level 7


Introduction: Pregnancy and the postpartum (perinatal) period represent a time of increased vulnerability to the onset and exacerbation of psychiatric difficulties. Anxiety disorders (ADs) in particular, are a leading mental health concern, affecting 1 in 5 perinatal women. Practice guidelines in Canada, the United States, and United Kingdom recommend non-pharmacological interventions as first-line treatments for perinatal ADs, but few well-established non-pharmacological interventions exist for this population. Cognitive behavioural therapy (CBT) is a first-line psychological treatment for ADs in the general population but its efficacy for perinatal ADs remains unclear. The objective of this study was to examine the efficacy of a group-based CBT for perinatal anxiety, when compared to what is most commonly offered for perinatal distress (i.e., psychoeducation).

Methods: Twenty-four pregnant (n = 4) and postpartum (n = 20) participants with a principal AD diagnosis were randomized to a six-session perinatal anxiety CBT (n = 12) or psychoeducation (PE; n = 12) group. Participants completed measures assessing anxiety (State-Trait Inventory for Cognitive and Somatic Anxiety), worry (Penn State Worry Questionnaire), depression (Edinburgh Postnatal Depression Scale) and accompanying symptoms (e.g., stress, quality of life, functional impairment, client satisfaction) at baseline and post-treatment. CBT participants also completed measures at 3-months post-treatment. Preliminary

Results: One CBT and four PE participants discontinued treatment. Significant reductions in anxiety, worry, and depression symptoms occurred for those in the CBT and PE groups from pre- to post-treatment but no time by group interactions were observed. The CBT group experienced a significant decrease in anxiety, worry, and depression symptoms from post-treatment to 3-month follow-up. Importantly, patient satisfaction outcomes indicated that 91% of CBT participants and 62.5% of PE participants were satisfied with services they received. Further, 91% of participants in CBT and 75% of PE participants indicated that the treatment helped them cope with their symptoms more effectively. Outcomes from an additional ~36 participants will be reported at the time of presentation.

Discussion: CBT and PE may both be effective treatments for perinatal ADs, however, drop-out rates were higher and patient satisfaction was lower in PE compared to CBT. Preliminary results should be interpreted with caution given the small sample size.
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