Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Postpartum Depression | Study protocol

A study protocol of mobile phone app-based cognitive behaviour training for the prevention of postpartum depression among high-risk mothers

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

The changes in China’s family planning policy in recent years have led to changes in the age structure of pregnant women, and the prevalence of postpartum depression (PPD) is also on the rise. Cognitive Behaviour Training (CBT) as an effective intervention is widely used for postpartum depression. However, the shortage and health disparities of mental health resources, the stigma of postpartum depression in postpartum women and the need for postpartum recovery and child care prevent postpartum women from seeking traditional face-to-face CBT. Therefore, the purpose of this proposed study is to examine the effect of mobile phone applications (App) based CBT on postpartum depression, anxiety, pressure and parenting sense of competence.

Methods

A double blind, randomized controlled trial will be used in this study to examine the effectiveness of App-based CBT in reducing the prevalence of postpartum depression compared with usual postpartum care in China. A total of 120 participants will be recruited in this study. The intervention consists of a weekly theme module app for continuous six weeks, each module including learning content and assignments. The control group received usual postpartum care content through the App. Outcome measures include postpartum depression, anxiety, pressure and parenting sense of competence at 0-, 3- and 6-month after the intervention.

Discussion

If our intervention is effective, it will provide a time-friendly and unrestricted intervention for the psychological care of perinatal women, which can effectively solve the shortage and unevenness of mental health resources.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1900020735​. Registered 15 January 2019.
Literature
1.
go back to reference Vos T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–59.CrossRef Vos T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–59.CrossRef
2.
go back to reference Network, G.B.o.D.C., Global Burden of Disease Study 2016 (GBD 2016) Causes of Death and Nonfatal Causes Mapped to ICD Codes., in Institute for Health Metrics and Evaluation (IHME). 2017. Network, G.B.o.D.C., Global Burden of Disease Study 2016 (GBD 2016) Causes of Death and Nonfatal Causes Mapped to ICD Codes., in Institute for Health Metrics and Evaluation (IHME). 2017.
3.
go back to reference American Psychiatric, A., D.S.M.T.F. American Psychiatric Association, and P. American Psychiatric. In: Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. ed. DSM-5. Arlington, VA: American Psychiatric Association; 2013.CrossRef American Psychiatric, A., D.S.M.T.F. American Psychiatric Association, and P. American Psychiatric. In: Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. ed. DSM-5. Arlington, VA: American Psychiatric Association; 2013.CrossRef
4.
go back to reference Stuart-Parrigon K, Stuart S. Perinatal Depression: an update and overview. Curr Psychiatry Rep. 2014;16(9):1–9.CrossRef Stuart-Parrigon K, Stuart S. Perinatal Depression: an update and overview. Curr Psychiatry Rep. 2014;16(9):1–9.CrossRef
5.
go back to reference Wisner K, Moses-Kolko E, Sit D. Postpartum depression: a disorder in search of a definition. Off J Section Women's Health World Psychiatr Assoc. 2010;13(1):37–40. Wisner K, Moses-Kolko E, Sit D. Postpartum depression: a disorder in search of a definition. Off J Section Women's Health World Psychiatr Assoc. 2010;13(1):37–40.
6.
go back to reference O'Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2013;28(1):3–12.CrossRef O'Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2013;28(1):3–12.CrossRef
7.
go back to reference Organization, W.H. Mental health ATLAS 2017; 2018. p. 68. Organization, W.H. Mental health ATLAS 2017; 2018. p. 68.
8.
go back to reference Hahn-Holbrook, J., T. Cornwell-Hinrichs, and I. Anaya, Economic and health predictors of National Postpartum Depression Prevalence: a systematic review, meta-analysis, and Meta-Regression of 291 Studies from 56 Countries, in Front. Psychiatry. 2018. Hahn-Holbrook, J., T. Cornwell-Hinrichs, and I. Anaya, Economic and health predictors of National Postpartum Depression Prevalence: a systematic review, meta-analysis, and Meta-Regression of 291 Studies from 56 Countries, in Front. Psychiatry. 2018.
9.
go back to reference Gavin IN, et al. Perinatal Depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5, Part 1):1071–83.CrossRef Gavin IN, et al. Perinatal Depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5, Part 1):1071–83.CrossRef
10.
go back to reference Parsons CE, et al. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull. 2012;101(1):57–79.CrossRef Parsons CE, et al. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull. 2012;101(1):57–79.CrossRef
11.
go back to reference Fisher J, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139.CrossRef Fisher J, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139.CrossRef
12.
go back to reference Chi X, et al. Screening for postpartum Depression and associated factors among women in China: a cross-sectional study.(survey). Front Psychol. 2016;7:1–8. Chi X, et al. Screening for postpartum Depression and associated factors among women in China: a cross-sectional study.(survey). Front Psychol. 2016;7:1–8.
13.
go back to reference Zhou C, et al. Social capital and antenatal depression among Chinese primiparas: a cross-sectional survey. Psychiatry Res. 2017;257:533–9.CrossRef Zhou C, et al. Social capital and antenatal depression among Chinese primiparas: a cross-sectional survey. Psychiatry Res. 2017;257:533–9.CrossRef
14.
go back to reference Deng A-W, et al. Prevalence and risk factors of postpartum depression in a population-based sample of women in Tangxia community, Guangzhou. Asian Pac J Trop Med. 2014;7(3):244–9.CrossRef Deng A-W, et al. Prevalence and risk factors of postpartum depression in a population-based sample of women in Tangxia community, Guangzhou. Asian Pac J Trop Med. 2014;7(3):244–9.CrossRef
15.
go back to reference Ribo X, et al. Prevalence and factors associated with postpartum depression in women from single-child families. Int J Gynecol Obstet. 2018;141(2):194–9.CrossRef Ribo X, et al. Prevalence and factors associated with postpartum depression in women from single-child families. Int J Gynecol Obstet. 2018;141(2):194–9.CrossRef
16.
go back to reference Kang C, et al. The Influence of the New Fertility Policy on Size and Structure of Maternity in Obstetric and Gynecologic Hospitals. Popul Res. 2015;39(6):85–93. Kang C, et al. The Influence of the New Fertility Policy on Size and Structure of Maternity in Obstetric and Gynecologic Hospitals. Popul Res. 2015;39(6):85–93.
17.
go back to reference Lean, S.C., et al., Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis, in PLoS One. 2017. Lean, S.C., et al., Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis, in PLoS One. 2017.
18.
go back to reference Koutra K, et al. Pregnancy, perinatal and postpartum complications as determinants of postpartum depression: the Rhea mother-child cohort in Crete, Greece. Epidemiol Psychiatr Sci. 2018;27(3):244–55.CrossRef Koutra K, et al. Pregnancy, perinatal and postpartum complications as determinants of postpartum depression: the Rhea mother-child cohort in Crete, Greece. Epidemiol Psychiatr Sci. 2018;27(3):244–55.CrossRef
19.
go back to reference Feki. R., et al., Impact of postpartum depression on quality of life. Eur Psychiatry. 2017:S901–2.CrossRef Feki. R., et al., Impact of postpartum depression on quality of life. Eur Psychiatry. 2017:S901–2.CrossRef
20.
go back to reference Farías-Antúnez S, Xavier MO, Santos IS. Effect of maternal postpartum depression on offspring's growth. J Affect Disord. 2018;228:143–52.CrossRef Farías-Antúnez S, Xavier MO, Santos IS. Effect of maternal postpartum depression on offspring's growth. J Affect Disord. 2018;228:143–52.CrossRef
21.
go back to reference Clout D, Brown R. Marital relationship and attachment predictors of postpartum stress, anxiety, and depression symptoms. J Soc Clin Psychol. 2016;35(4):322–41.CrossRef Clout D, Brown R. Marital relationship and attachment predictors of postpartum stress, anxiety, and depression symptoms. J Soc Clin Psychol. 2016;35(4):322–41.CrossRef
22.
go back to reference Eberhard-Gran M, Eskild A, Opjordsmoen S. Use of psychotropic medications in treating mood disorders during lactation. CNS Drugs. 2006;20(3):187–98.CrossRef Eberhard-Gran M, Eskild A, Opjordsmoen S. Use of psychotropic medications in treating mood disorders during lactation. CNS Drugs. 2006;20(3):187–98.CrossRef
23.
go back to reference Jesse DE, et al. Performance of a culturally tailored cognitive-behavioral intervention integrated in a public health setting to reduce risk of antepartum Depression: a randomized controlled trial. J Midwifery Women's Health. 2015;60(5):578–92.CrossRef Jesse DE, et al. Performance of a culturally tailored cognitive-behavioral intervention integrated in a public health setting to reduce risk of antepartum Depression: a randomized controlled trial. J Midwifery Women's Health. 2015;60(5):578–92.CrossRef
24.
go back to reference Farrand P, Woodford J. Effectiveness of cognitive Behavioural self-help for the treatment of Depression and anxiety in people with long-term physical health conditions: a systematic review and meta-analysis of randomised controlled trials. Ann Behav Med. 2015;49(4):579–93.CrossRef Farrand P, Woodford J. Effectiveness of cognitive Behavioural self-help for the treatment of Depression and anxiety in people with long-term physical health conditions: a systematic review and meta-analysis of randomised controlled trials. Ann Behav Med. 2015;49(4):579–93.CrossRef
25.
26.
go back to reference Gelenberg A, et al. PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder Third Edition. Am J Psychiatry. 2010;167(10):1–3 9-11,13–118. Gelenberg A, et al. PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder Third Edition. Am J Psychiatry. 2010;167(10):1–3 9-11,13–118.
27.
go back to reference Patel V, et al. The magnitude of and health system responses to the mental health treatment gap in adults in India and China. Lancet. 2016;388(10063):3074–84.CrossRef Patel V, et al. The magnitude of and health system responses to the mental health treatment gap in adults in India and China. Lancet. 2016;388(10063):3074–84.CrossRef
28.
go back to reference Thomas LJ, Scharp KM, Paxman CG. Stories of postpartum Depression: exploring health constructs and help-seeking in mothers’ talk. Women Health. 2014;54(4).CrossRef Thomas LJ, Scharp KM, Paxman CG. Stories of postpartum Depression: exploring health constructs and help-seeking in mothers’ talk. Women Health. 2014;54(4).CrossRef
29.
go back to reference Oʼmahen AH, et al. Stigma and Depression during pregnancy: does race matter? J Nerv Ment Dis. 2011;199(4):257–62.CrossRef Oʼmahen AH, et al. Stigma and Depression during pregnancy: does race matter? J Nerv Ment Dis. 2011;199(4):257–62.CrossRef
30.
go back to reference Baker-Ericzen MJ, et al. A collaborative care telemedicine intervention to overcome treatment barriers for Latina women with depression during the perinatal period. Fam Syst Health. 2012;30(3):224.CrossRef Baker-Ericzen MJ, et al. A collaborative care telemedicine intervention to overcome treatment barriers for Latina women with depression during the perinatal period. Fam Syst Health. 2012;30(3):224.CrossRef
31.
go back to reference Klein JP, et al. Time to remission from mild to moderate depressive symptoms: one year results from the EVIDENT-study, an RCT of an internet intervention for depression. Behav Res Ther. 2017;97:154–62.CrossRef Klein JP, et al. Time to remission from mild to moderate depressive symptoms: one year results from the EVIDENT-study, an RCT of an internet intervention for depression. Behav Res Ther. 2017;97:154–62.CrossRef
32.
go back to reference March S, Spence SH, Donovan CL. The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. J Pediatr Psychol. 2009;34(5):474–87.CrossRef March S, Spence SH, Donovan CL. The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. J Pediatr Psychol. 2009;34(5):474–87.CrossRef
33.
go back to reference Coulson N, et al. The pros and cons of getting engaged in an online social community embedded within digital cognitive behavioral therapy for insomnia: survey among users. J Med Internet Res. 2016;18(4):E88.CrossRef Coulson N, et al. The pros and cons of getting engaged in an online social community embedded within digital cognitive behavioral therapy for insomnia: survey among users. J Med Internet Res. 2016;18(4):E88.CrossRef
34.
go back to reference Chang-hai H. Analysis of the smart phone market in the first half of 2016. China Internet. 2016;13(10):74–6. Chang-hai H. Analysis of the smart phone market in the first half of 2016. China Internet. 2016;13(10):74–6.
35.
go back to reference Lee D, et al. Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh postnatal Depression scale. Br J Psychiatry. 1998;172:433–7.CrossRef Lee D, et al. Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh postnatal Depression scale. Br J Psychiatry. 1998;172:433–7.CrossRef
36.
go back to reference Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression anxiety stress scales (DASS) with the Beck Depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43.CrossRef Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression anxiety stress scales (DASS) with the Beck Depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43.CrossRef
37.
go back to reference Wen Y, Da-Xing WU, Xue-Jing L. Psychometric properties of the Chinese short version of Depression anxiety and stress scale in Chinese adults. Chin J Public Health. 2012. Wen Y, Da-Xing WU, Xue-Jing L. Psychometric properties of the Chinese short version of Depression anxiety and stress scale in Chinese adults. Chin J Public Health. 2012.
38.
go back to reference Gibaudwallston, J., Self-esteem and situational stress: factors related to sense of competence in new parents. Wallston, 1978. Gibaudwallston, J., Self-esteem and situational stress: factors related to sense of competence in new parents. Wallston, 1978.
39.
go back to reference Xiao Y, et al. The reliability and validity of the Chinese version of parenting sense of competence scale. Chin J Nurs. 2014;7:881–5. Xiao Y, et al. The reliability and validity of the Chinese version of parenting sense of competence scale. Chin J Nurs. 2014;7:881–5.
40.
go back to reference Jones BA, et al. Online cognitive behaviour training for the prevention of postnatal depression in at-risk mothers: a randomised controlled trial protocol. BMC Psychiatry. 2013;13(1):265.CrossRef Jones BA, et al. Online cognitive behaviour training for the prevention of postnatal depression in at-risk mothers: a randomised controlled trial protocol. BMC Psychiatry. 2013;13(1):265.CrossRef
42.
go back to reference Rahman A, et al. Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis. In: Bull. World health organ; 2013. p. 593–601. Rahman A, et al. Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis. In: Bull. World health organ; 2013. p. 593–601.
43.
go back to reference Pugh N, et al. Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study. Off J Section Women's Health World Psychiatr Assoc. 2015;18(2):209–19. Pugh N, et al. Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study. Off J Section Women's Health World Psychiatr Assoc. 2015;18(2):209–19.
Metadata
Title
A study protocol of mobile phone app-based cognitive behaviour training for the prevention of postpartum depression among high-risk mothers
Publication date
01-12-2019
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6941-8

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue