title: Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence.
abstract: OBJECTIVE
  Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their health care providers. Pregnant women with histories of depression report preference for nonpharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU).
  
  
  METHODS
  Pregnant adult women with depression histories were recruited from obstetric clinics at 2 sites and randomized to MBCT-PD (N = 43) or TAU (N = 43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6 months postpartum.
  
  
  RESULTS
  Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared with participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study.
  
  
  CONCLUSIONS
  MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive-behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in many women's lives.
authors.affiliation: Department of Psychology and Neuroscience, University of Colorado Boulder.
authors.forename: Sona
authors.initials: S
authors.lastname: Dimidjian
authors.affiliation: Department of Psychology, Emory University.
authors.forename: Sherryl H
authors.initials: SH
authors.lastname: Goodman
authors.affiliation: Department of Psychology and Neuroscience, University of Colorado Boulder.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Felder
authors.affiliation: Department of Mathematics, Applied Statistics Program, West Chester University.
authors.forename: Robert
authors.initials: R
authors.lastname: Gallop
authors.affiliation: Department of Psychology, Emory University.
authors.forename: Amanda P
authors.initials: AP
authors.lastname: Brown
authors.affiliation: Kaiser Permanente Colorado-Institute for Health Research.
authors.forename: Arne
authors.initials: A
authors.lastname: Beck
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000517:prevention & control*; D019052:Depression, Postpartum / Q000517:prevention & control*; D005260:Female; D006801:Humans; D064866:Mindfulness / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D012008:Recurrence; D016896:Treatment Outcome