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J Perinat Neonatal Nurs. 2014 Jul-Sep;28(3):185-95. doi: 10.1097/JPN.0000000000000027.

Early intervention in pregnant women with elevated anxiety and depressive symptoms: efficacy of a cognitive-behavioral group program.

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  • 1Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Saxony, Germany (Drs Bittner, Peukert, Junge-Hoffmeister, and Weidner, Ms Zimmermann), Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Saxony, Germany (Ms Zimmermann), Center for Bioethics and Health Law, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Parker); and Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany (Dr Stöbel-Richter).


To examine whether a cognitive-behavioral group program among pregnant women with elevated levels of anxiety or depression may reduce anxious and depressive symptoms and has a positive impact on risk factors for anxiety disorders and depression. A total of 753 participants were recruited. After completion of the clinical standardized interview, 160 participants were randomized to an intervention group or a control condition. Psychometric assessments took place at T1 (preintervention), T2 (antenatal follow-up), and T3 (3 months postpartum). Analyses included women who took part in all 3 assessments (intervention group, N = 21; control group, N = 53). The subjective program evaluation by the participants was highly positive, but with the exception of a short-term effect on the quality of an intimate partnership (F1/67 = 4.056; P < .05], intervention effects on anxiety or depressive symptoms were not found. However, there was an intervention effect 3 months postpartum for participants with high depressive symptoms at T1 (Edinburgh Postnatal Depression Scale score of ≥10) (F1/69 = 5.410; P < .05). The results argue against a general efficacy of a cognitive-behavioral group program for pregnant women with rather low levels of anxiety and depression. For women with higher depressive symptoms during pregnancy, a cognitive-behavioral group program may have a positive impact on the course of depressive symptoms during the postpartum period.

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