Mamma Mia - A randomized controlled trial of an internet-based intervention for perinatal depression.

Silje Marie Haga,Kari Slinning,Carina Lisøy,Tore Wentzel-Larsen,Filip Drozd

doi:10.1017/s0033291718002544

Abstract

Studies suggest that 10-15% of perinatal women experience depressive symptoms. Due to the risks, problems with detection, and barriers to treatment, effective universal preventive interventions are needed. The aim of this study was to assess the effectiveness of an automated internet intervention ('Mamma Mia') on perinatal depressive symptoms. Mamma Mia is tailored specifically to the perinatal phase and targets risk and protective factors for perinatal depressive symptoms. A total of 1342 pregnant women were randomized to an intervention ('Mamma Mia') and control group. Data were collected at gestational week (gw) 21-25, gw37, 6 weeks after birth, and 3 and 6 months after birth. We investigated whether (1) the intervention group displayed lower levels of depressive symptoms compared with the control group, (2) the effect of Mamma Mia changed over time, (3) the effect on depressive symptoms was moderated by baseline depressive symptoms, previous depression, and parity, and (4) this moderation changed by time. Finally, we examined if the prevalence of mothers with possible depression [i.e. Edinburgh Postnatal Depression Scale (EPDS)-score ⩾10] differed between the intervention and control group. Participants in the Mamma Mia group displayed less depressive symptoms than participants in the control group during follow-up [F(1) = 7.03, p = 0.008]. There were indications that the effect of Mamma Mia was moderated by EPDS score at baseline. The prevalence of women with EPDS-score ⩾10 was lower in the Mamma Mia group at all follow-up measurements. The study demonstrated the effects of the automated web-based universal intervention Mamma Mia on perinatal depressive symptoms.

Highlights

The perinatal period represents a time signified by much emotional turmoil for women, and studies suggest that 10–15% of women experience moderate to high levels of depressive symptoms during this period (O’Hara and Swain, 1996; Eberhard-Gran et al, 2004; Gavin et al, 2005)
Our study aims to contribute to the understanding of the effectiveness of fully automated web-based preventive interventions for perinatal depression
We examined if the prevalence of mothers with at least a probable minor depression (i.e. Edinburgh Postnatal Depression Scale (EPDS)-score ⩾10) differed between the intervention and control group

Summary

Introduction

The perinatal period represents a time signified by much emotional turmoil for women, and studies suggest that 10–15% of women experience moderate to high levels of depressive symptoms during this period (O’Hara and Swain, 1996; Eberhard-Gran et al, 2004; Gavin et al, 2005). Highlight how women seem to be at equal risk of developing depression during pregnancy (Melville et al, 2010), and approximately 50% of depressive episodes after birth, start during pregnancy (American Psychiatric Association, 2013). This underscores the importance of early intervention, as the chronicity of depressive symptoms is of particular concern for the consequences of depression (Sohr-Preston and Scaramella, 2006). The study demonstrated the effects of the automated web-based universal intervention Mamma Mia on perinatal depressive symptoms

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