Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not, “Is electronically-delivered cognitive therapy effective in producing remission from clinical depression in postpartum women by 15 weeks after start of treatment?”

STUDY DESIGN: Review of three randomized controlled trials (RCTs).

DATA SOURCES: All studies were published in peer-reviewed journals found via the use of PubMed and Embase.

OUTCOME(S) MEASURED: The outcome measured was active or remissive diagnosis of postpartum depression. This was measured using either the SCID-IV to determine DSM-IV diagnosis or the Edinburg Postnatal Depression Scale.

RESULTS: Three randomized controlled trials were included and analyzed in this review. The study by Milgrom et al showed a statistically significant increase (p = 0.001) in remission from clinical postpartum depression among patients receiving electronic cognitive behavioral therapy (CBT) through a program named MumMoodBooster compared to patients receiving treatment as usual, with a numbers needed to treat (NNT) of 2. The second study by Pugh et al demonstrated initial data with a p-value of 0.08, and follow up data showing a statistically significant increase (p <0.01) in remission from clinical postpartum depression among patients receiving electronic CBT via a website called Maternal Depression Online compared to wait list control patients, with an NNT of 5. The third study by O’Mahen et al showed a statistically significant increase (p <0.001) in recovery from psotpartum depression among patients receiving electronic CBT through a program named Netmums compared to treatment as usual, with a NNT of 6.

CONCLUSIONS: The results of these randomized controlled trials indicate that electronicallydelivered cognitive therapy is an effective treatment option for postpartum depression.

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