Importance Postpartum depression (PPD) affects as many as 20% of mothers, yet just 1 in 10 of these women receives evidence-based treatment. The COVID-19 pandemic has increased PPD risk, reduced treatment access, and shifted preferences toward virtual care. Objective To determine whether an online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual improves PPD, anxiety, social support, mother-infant relationship quality, and infant temperament more than treatment as usual alone. Design, Setting, and Participants This randomized clinical trial included 403 women with PPD who were recruited across Ontario, Canada, during the COVID-19 pandemic (April 20 to October 4, 2020). Women with Edinburgh Postnatal Depression Scale (EPDS) scores of at least 10 who were 18 years or older and had an infant younger than 12 months were eligible. Interventions Women were randomly assigned to receive a live, interactive online 1-day CBT-based workshop delivered by a registered psychotherapist, psychiatrist, or clinical psychology graduate student in addition to treatment as usual (n = 202) or to receive treatment as usual and wait-listed to receive the workshop 12 weeks later (n = 201). Main Outcomes and Measures The primary outcome was change in PPD (EPDS scores) in experimental and wait list control groups 12 weeks after baseline. Secondary outcomes included maternal anxiety (7-item Generalized Anxiety Disorder Questionnaire [GAD-7]), social support (Social Provisions Scale), quality of the mother-infant relationship (Postpartum Bonding Questionnaire), and infant temperament (Infant Behavior Questionnaire-Revised Very Short Form). Results Participants all identified as women with a mean (SD) age of 31.8 (4.4) years. The workshop led to significant mean (SD) reductions in EPDS scores (from 16.47 [4.41] to 11.65 [4.83]; B = -4.82; P < .001) and was associated with a higher odds of exhibiting a clinically significant decrease in EPDS scores (odds ratio, 4.15; 95% CI, 2.66-6.46). The mean (SD) GAD-7 scores decreased from 12.41 (5.12) to 7.97 (5.54) after the workshop (B = -4.44; 95% CI, -5.47 to -3.38; P < .001) and participants were more likely to experience a clinically significant change (odds ratio, 3.09; 95% CI, 1.99-4.81). Mothers also reported improvements in bonding (B = -3.22; 95% CI, -4.72 to -1.71; P < .001), infant-focused anxiety (B = -1.64; 95% CI, -2.25 to 1.00; P < .001), social support (B = 3.31; 95% CI, 1.04 to 5.57; P < .001), and positive affectivity/surgency in infants (B = 0.31; 95% CI, 0.05 to 0.56; P < .001). Conclusions and Relevance In this randomized clinical trial, an online 1-day CBT-based workshop for PPD provides an effective, brief option for mothers, reducing PPD and anxiety as well as improving social support, the mother-infant relationship, and positive affectivity/surgency in offspring. Trial Registration ClinicalTrials.gov Identifier: NCT04485000.

中文翻译：

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基于在线 1 天认知行为疗法的研讨会加上常规护理与单独常规护理对产后抑郁症的影响：一项随机临床试验。

重要性 产后抑郁症 (PPD) 影响多达 20% 的母亲，但这些女性中只有十分之一接受了循证治疗。COVID-19 大流行增加了 PPD 风险，减少了治疗机会，并将偏好转向虚拟护理。目的 确定在常规治疗的基础上加入为期 1 天的在线认知行为疗法 (CBT) 研讨会是否比单独常规治疗更能改善 PPD、焦虑、社会支持、母婴关系质量和婴儿气质。设计、设置和参与者这项随机临床试验包括在 COVID-19 大流行期间（2020 年 4 月 20 日至 10 月 4 日）在加拿大安大略省招募的 403 名 PPD 女性。爱丁堡产后抑郁量表（EPDS）评分至少为 10 岁、18 岁或以上且婴儿小于 12 个月的女性符合条件。干预 女性被随机分配接受由注册心理治疗师、精神科医生或临床心理学研究生提供的为期 1 天的现场互动在线 CBT 研讨会，除了照常治疗 (n = 202) 或照常接受治疗和等待 12 周后接受研讨会（n = 201）。主要结果和测量 主要结果是基线后 12 周实验组和候补名单对照组 PPD（EPDS 评分）的变化。次要结局包括产妇焦虑（7 项广义焦虑障碍问卷 [GAD-7]）、社会支持（社会规定量表）、母婴关系的质量（产后结合问卷）和婴儿气质（婴儿行为问卷 - 修订的非常简短的表格）。结果 参与者均被确定为平均 (SD) 年龄为 31.8 (4.4) 岁的女性。研讨会导致 EPDS 评分的平均 (SD) 显着降低（从 16.47 [4.41] 到 11.65 [4.83]；B = -4.82；P < .001），并且与 EPDS 临床显着降低的几率更高有关分数（优势比，4.15；95% CI，2.66-6.46）。研讨会结束后，平均 (SD) GAD-7 分数从 12.41 (5.12) 降至 7.97 (5.54)（B = -4.44；95% CI，-5.47 至 -3.38；P < .001），参与者更有可能经历临床显着变化（优势比，3.09；95% CI，1.99-4.81）。母亲们还报告了亲密关系的改善（B = -3.22；95% CI，-4.72 至 -1.71；P < .001），以婴儿为中心的焦虑（B = -1.64；95% CI，-2.25 至 1.00；P < .001），社会支持（B = 3.31；95% CI，1.04 至 5.57；P < .001），和婴儿的积极情感/冲动（B = 0.31；95% CI，0.05 至 0.56；P < .001）。结论和相关性 在这项随机临床试验中，为期 1 天的基于 CBT 的 PPD 在线研讨会为母亲提供了一个有效、简短的选择，减少 PPD 和焦虑，并改善社会支持、母婴关系和积极的情感/后代的激增。试验注册 ClinicalTrials.gov 标识符：NCT04485000。结论和相关性 在这项随机临床试验中，为期 1 天的基于 CBT 的 PPD 在线研讨会为母亲提供了一个有效、简短的选择，减少 PPD 和焦虑，并改善社会支持、母婴关系和积极的情感/后代的激增。试验注册 ClinicalTrials.gov 标识符：NCT04485000。结论和相关性 在这项随机临床试验中，为期 1 天的基于 CBT 的 PPD 在线研讨会为母亲提供了一个有效、简短的选择，减少 PPD 和焦虑，并改善社会支持、母婴关系和积极的情感/后代的激增。试验注册 ClinicalTrials.gov 标识符：NCT04485000。