The Weekly Mind Reader: Nurse-Lead CBT Delivered Online Shows Benefit for Postpartum Depression

by Staff Writer
July 28, 2023 at 9:05 AM UTC

In this week’s Mind Reader, we take a deep dive into why PANDAS diagnosis can be so problematic and debut a new regular feature.

Cognitive behavioral therapy, or CBT, is a type of talk therapy that focuses on the relationship between a person’s thoughts, feelings, and behaviors. It’s based on the idea that negative self-talk contributes to mental health problems, and aims to “reprogram” destructive thought and behavior patterns into healthier ones.

CBT has a reputation for being productive and easy to deliver. One meta-analysis found that CBT outperformed standard care in treating depression. Another study showed that it was just as good as medication in panic disorder, with 70 percent of CBT participants demonstrating significant improvement. And more than half of CBT participants in another study no longer met the diagnostic criteria for PTSD, more than double the success rate for those who received the usual care alone. 

CBT For Postpartum Depression

Now, a new The Journal of Clinical Psychiatry study suggests that online group CBT sessions delivered by public health nurses can effectively treat postpartum depression (PPD). The study randomized 159 mothers in Ontario, Canada to either receive CBT plus their regular treatment or their usual treatment alone. They attended several Zoom calls weekly, working on CBT strategies within groups over nine weeks of treatment.

Moms who attended the online sessions had a significant reduction in depression, with 27 percent of them no longer meeting the diagnostic criteria. By comparison, just 2.5 percent of those who received regular treatment by itself saw the same level of benefit. The Zoom therapy sessions reduced worry by almost six points on a 50-point scale and emotional anger towards infants by nearly a third on a 5-point scale. The improvements persisted for at least six months after the therapy ended.

CBT is typically delivered by mental health professionals who have specialized training. This includes psychiatrists, psychologists, and social workers. The findings of this study indicate that public health nurses can be added to the list of health providers who can be trained to teach online CBT in a way that works. 

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS THIS WEEK

  • Rumination increases the risk of severe depression, but resilience can help mitigate that risk.
  • While Black individuals have the highest rate of emergency department mental health visits, when adjusted for factors like insurance and health conditions, a new study finds no significant differences among racial or ethnic groups. 
  • In a new “Rounds at the General Hospital” feature, experts delve into the diagnosis of treatment-resistant depression and the best course of management. 
  • A patient presented with psychosis. A subsequent examination revealed a serious neurological condition in this case study.
  • Dementia contributes to more than 1.4 million emergency room visits yearly, highlighting the need for increased resources and support for caregivers.
  • Our Post of the Week features Triple Board Resident Russell Ledet, MD, who is also an advocate for diversity and fairness in medicine. His guest essay on Psychiatrist.com is a must read. 

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Letter to the Editor

Prevalence of Psychiatric Disorders in Women With Obstetric Complications: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III

Obstetric complications are associated with a higher prevalence of mood and anxiety disorders during the perinatal period.

Marine Jacquelin and others

Case Report

Two Cases of Montelukast-Associated Psychosis in Children

Two children experienced auditory visual hallucinations after taking montelukast for 1 to 2 days for asthma.

Wisam Al Jumaili and others