Abstract
Cognitive–behavioral interventions can effectively treat symptoms of perinatal mood and anxiety disorders (PMADs). We assessed the acceptability and effectiveness of a workbook-based intervention (What Am I Worried About? (WAWA)) comprising of cognitive–behavioral and mindfulness techniques and weekly professional guidance to address symptoms of depression, anxiety, and stress among postpartum mothers. We compared the efficacy of group versus individual telephone consultation using a pre-and post-test single group, open trial, research design in replication pilot study. A convenience sample of community-residing postpartum women (n = 34) chose between group intervention (n = 24) or individual phone consultation with a mental health professional (n = 10). Outcome measures were anxiety (GAD-7), depression, anxiety, and stress (DASS21), and postpartum depression (PPD-EPDS). After four weeks intervention, significant reductions were observed in postpartum depression, anxiety, and stress scales. Cohen’s d statistics showed medium effect sizes (0.35–0.56). A small but significantly larger change in PPD-EPDS and DASS stress scores was reported among participants who opted for the phone intervention compared to those in the group intervention. Most participants felt that the intervention was highly beneficial and would recommend it to other postpartum women. In conclusion, the WAWA intervention showed efficacy for reducing postpartum anxiety, distress, and depressive symptoms among postpartum women, with a slightly greater reduction in PPD-EPDS and stress symptoms found among those who opted for individual phone consultation. Definitive evaluation of the intervention requires a larger sample and a RCT research design with two treatment arms: telephone and group intervention.
Highlights
The prevalence of perinatal mood and anxiety disorders (PMAD, formerly called postpartum depression, PPD) in the general population worldwide is estimated at 10– 20% [1,2]
A small but significantly larger change in PPD-EPDS and DASS stress scores was reported among participants who opted for the phone intervention compared to those in the group intervention
What Am I Worried About (WAWA) is a workbook developed in Melbourne, Australia by Rowe and Fisher to provide a low-cost, accessible method for treating postpartum women who experience mild to moderate symptoms of PMAD [4]
Summary
The prevalence of perinatal mood and anxiety disorders (PMAD, formerly called postpartum depression, PPD) in the general population worldwide is estimated at 10– 20% [1,2]. Women who suffer from PMAD are vulnerable to emotional and physical risks, and symptoms of PMAD can have a negative effect on their infant’s development [3]. Previous studies stressed the importance of choosing the suitable intervention format for postpartum women [7,8]. Safe, effective, individually tailored, and nonpharmaceutical methods for the prevention and treatment of postpartum mental health problems are recommended [9]. What Am I Worried About (WAWA) is a workbook developed in Melbourne, Australia by Rowe and Fisher to provide a low-cost, accessible method for treating postpartum women who experience mild to moderate symptoms of PMAD [4]. WAWA combines cognitive behavior and mindfulness techniques and can be delivered in person to individuals or within a group meeting, by telephone or ZOOM consultations with the guidance of a mental health professional
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