One-Day Online Cognitive Behavioral Therapy-Based Workshops for the Prevention of Postpartum Depression: A Randomized Controlled Trial.

Background: Postpartum depression (PPD) affects up to 1 in 5 birthing parents and is associated with more future depressive episodes. We aimed to determine if PPD could be prevented with online 1-day cognitive behavioral therapy (CBT)-based workshops. Methods: This randomized controlled trial enrolled pregnant persons at 28-38 weeks gestation at increased risk for PPD, living in Ontario and free of current DSM-5 major depressive disorder (MDD). Participants received the workshop plus treatment as usual (TAU; experimental group) or TAU alone (control group). We assessed MDD diagnosis, levels of PPD symptoms, anxiety, social support, mother-infant relationship, and infant temperament at 1, 2, and 3 months postpartum. The primary outcome was MDD at 3 months postpartum assessed using the Mini-International Neuropsychiatric Interview. Results: Since <10% of participants developed MDD, trial recruitment was stopped early. Data were collected up to 2 months postpartum in those already enrolled. Among these participants (n = 124), reductions in Edinburgh Postnatal Depression Scale (EPDS) scores were seen in the experimental group at 2 months but were not statistically significant (P = .06). Higher risk participants (baseline EPDS ≥7) in the experimental group showed larger, statistically significant reductions (P<.05) in PPD and anxiety at 2 months postpartum. Limitations: Eligibility criteria resulted in a sample that did not develop MDD at rates high enough to continue the trial and limited study statistical power. Conclusions: Definitive conclusions regarding the effectiveness of online 1-day workshops for preventing PPD are not possible, but these results may warrant future testing with a higher risk sample. Trial Registration: ClinicalTrials.gov identifier: NCT05753176.