Tuesday, February 28, 2023

Moderated Online Postpartum Group May Help Moms With Postpartum Depression

Postpartum depression—which can disrupt the forming of bonds between a mother and child—is estimated to impact between 12% and 24% of women following the birth of a child. A study in Pediatrics now suggests that women with postpartum depression who participate in a parenting program via Facebook may experience more rapid symptom improvements than those who do not participate in such a program. However, participation in the parenting program via Facebook may not impact parenting stress or responsiveness.

“Our study is among the first to examine the effects of a parenting program administered through a social media platform,” wrote James P. Guevara, M.D., M.P.H., of Children’s Hospital of Philadelphia and colleagues. “Social media may be an important platform to provide parenting support for women with [postpartum depression] symptoms when in-person participation is difficult … .”

Guevara and colleagues recruited mothers over age 18 years who screened positive for minor to moderate depression symptoms on the Edinburgh Postnatal Depression Scale (EPDS=10-19). To be included in the study, mothers were also required to read and write in English and have access to a smartphone or tablet. Seventy-five women were randomized into one of two groups for the three-month study: One group was invited to participate in the Parenting With Depression secret Facebook group and an online cognitive-behavioral therapy (CBT) program called MoodGym; the other group was invited to participate in MoodGym only. Participants in both groups also received a list of community mental health resources.

The Parenting With Depression intervention consisted of eight weekly topics (for example, psychoeducation and parent-child interactions), released in three separate posts to the Facebook group over the course of the week. The posts included videos, narrated PowerPoint presentations, and written materials. Participants were encouraged to “friend” other group members and respond to their posts. A facilitator reviewed posts, commented on posts, and provided tips for group members.

Study participants were evaluated monthly using the EPDS. Additionally, at the start of the study and again three months later, the participants were assessed on their levels of stress, parent-child interactions, parenting self-esteem, and more. Women whose EPDS scores exceeded 20 or who reported suicidality were contacted by a psychologist to assess risk; those deemed to be at high risk were referred for further care and were excluded from further participation in the study.

Participants assigned to the Facebook group intervention experienced a more rapid decline of depressive symptoms than those assigned to online CBT only, with differences between the two groups emerging at one month. While both groups demonstrated what the authors termed “modest improvements in responsive parenting,” there was no difference between the two groups on this measure over time.

Guevara and colleagues noted that the data were collected during “the height of the COVID-19 pandemic,” which may have led to less engagement with the Facebook group intervention. “Only 9 (28%) of the intervention group participants viewed and posted comments to at least one-third of the weekly content,” they wrote. “[W]e found that women who engaged this much had greater improvements in responsive parenting than those with less engagement. This suggests that passively viewing content is not as helpful as engaging in the exercises and interacting with other participants and the study facilitator.

They concluded, “[G]reater attention to participant engagement and ensuring and accounting for mental health treatment are needed to improve parenting outcomes with social media-based parenting programs.”

For related information, see the Psychiatric News article “Women With Postpartum Depression May Benefit From One-Day Online Workshop.”

(Image: iStock/lakshmiprasad S)

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