Nonpharmacologic Treatments for Maternal Mental Health Conditions

Social Workers

4.50 - CE credit hours training

$28.00 - Cost of course

This page contains important information about the course, including training details, a comprehensive course description, learning objectives, and source references. We encourage you to review each section to gain a clear understanding of the course content, educational goals, and supporting materials before beginning your training and taking the POST TEST below.

Target audience and instructional level of this course: foundational
There is no known conflict of interest or commercial support related to this CE program.

Nonpharmacologic Treatments for Maternal Mental Health Conditions

Course Training

Content for this course is pages ES1 to page 3 and pages 16 to 101.

https://effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-271-mental-health-pregnant.pdf

Post Test

27 Questions

1. Which of the following nonpharmacologic treatments showed moderate strength of evidence for reducing depressive symptoms in perinatal individuals, according to the reviewed studies?

a. Bright light therapy b. Non-directive counseling c. Specific acupuncture d. Cognitive Behavioral Therapy (CBT) e. Behavioral Activation (BA)

2. The majority of studies included in this review were conducted in which two countries?

a. Canada and Australia b. United States and the United Kingdom c. Sweden and Hong Kong d. Germany and Italy e. Australia and Sweden

3. What diagnostic criteria were most frequently used in the studies to identify participants with depressive or anxiety disorders?

a. International Classification of Diseases (ICD-10) b. Adult Attachment Interview (AAI) c. Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria (DSM-IV or DSM-IV-TR) d. Munich-Composite International Diagnostic Interview e. Impact of Events Scale

4. What was the most prevalent type of perinatal mental health disorder among participants in the included studies?

a. Anxiety disorders b. Post-traumatic stress disorder (PTSD) c. Obsessive-compulsive disorder (OCD) d. Depressive disorder e. Bipolar disorder

5. What was the median percentage of White participants across the included studies?

a. 26.0% b. 16.5% c. 7.5% d. 4.0% e. 65.2%

6. What percentage of the studies reported on participants' marital status?

a. 38% b. 55% c. 80% d. 88% e. 57%

7. Besides CBT and IPT, which nonpharmacologic intervention showed effectiveness in reducing depressive symptoms in perinatal individuals with depressive disorders (though with a lower strength of evidence)?

a. Bright light therapy b. Non-directive counseling c. Specific acupuncture d. Eye Movement Desensitization and Reprocessing (EMDR) e. Behavioral Activation (BA)

8. For perinatal individuals with anxiety disorders, the review found:

a. Strong evidence supporting CBT's effectiveness. b. Moderate evidence supporting exercise interventions. c. Insufficient evidence to draw conclusions due to heterogeneity. d. Clear superiority of IPT over TAU. e. That BA was more effective than TAU.

9. In studies comparing specific and nonspecific acupuncture, what was the primary outcome measure used to assess depressive symptoms?

a. EPDS b. GAD-7 c. BDI d. HAM-D e. PHQ-9

10. The meta-analysis of specific versus nonspecific acupuncture showed a significant difference in which outcome?

a. End-of-treatment depressive symptom scores b. Response rate of depressive symptoms c. Remission rate of depressive symptoms d. Both b and c e. None of the above

11. What was the most common concern regarding risk of bias in studies on behavioral activation (BA)?

a. Blinding of outcome assessors b. Blinding of participants and personnel c. Allocation concealment d. Attrition bias e. Selective reporting

12. In the behavioral activation studies, what was the statistically significant finding regarding depressive symptoms?

a. Higher anxiety scores in the BA group. b. No significant difference in depressive symptoms. c. Lower depressive symptoms in the BA group. d. Higher remission rates in the TAU group. e. Increased perceived stress in the BA group.

13. The meta-analysis of bright light therapy versus placebo light therapy showed:

a. Strong evidence supporting bright light therapy. b. Insufficient evidence to determine a significant difference. c. Clear superiority of placebo light therapy. d. Significant reduction in depressive symptoms with bright light therapy. e. That placebo light therapy was more effective.

14. In the studies comparing CBT and non-directive counseling, what was a common concern regarding risk of bias?

a. Blinding of outcome assessors b. Attrition bias c. Blinding of participants and personnel d. Selective reporting e. Intention-to-treat analysis

15. The review identified insufficient evidence for nonpharmacologic treatments for which perinatal mental health condition?

a. Depressive disorders b. Anxiety disorders c. Combined depressive and anxiety disorders d. Bipolar disorder e. Post-traumatic stress disorder (PTSD)

16. Which scale was used in multiple studies to measure perceived stress?

a. Work and Social Adjustment Scale (WSAS) b. Perceived Availability of Social Support c. Perceived Stress Scale (PSS) d. Client Satisfaction Questionnaire (CSQ-8) e. Social Provision Scale

17. The study by Dimidjian 2017 used which scale to measure changes in behaviors thought to underlie depression?

a. Environmental Reward Observation Scale (EROS) b. Behavioral Activation for Depression Scale (BADS) c. Patient Health Questionnaire (PHQ-9) d. Beck Depression Inventory (BDI) e. Generalized Anxiety Disorders Scale (GAD-7)

18. Which scale measured participants' functional impairment in the O'Mahen 2014 study?

a. Client Satisfaction Questionnaire (CSQ-8) b. Work and Social Adjustment Scale (WSAS) c. Perceived Stress Scale (PSS) d. Social Provision Scale e. Behavioral Activation for Depression Scale (BADS)

19. What was the main finding regarding the comparison of CBT and non-directive counseling on depressive symptoms?

a. CBT was significantly more effective) b. Non-directive counseling was significantly more effective. c. There was no significant difference. d. Insufficient evidence to determine a difference. e. There was significant heterogeneity.

20. What was a limitation of the studies examining bright light therapy?

a. Large sample sizes b. Low risk of bias across all domains. c. High precision of effect estimates. d. Low number of participants reaching remission. e. Consistent findings across studies.

21. Which study used the Adult Attachment Interview (AAI) to define PTSD?

a. Manber 2004 b. Manber 2010 c. Chung 2012 d. One unspecified German study e. One study not specified by name

22. The review primarily focused on the comparative effectiveness of which type of treatments?

a. Pharmacologic b. Surgical c. Nonpharmacologic d. Combined pharmacologic and nonpharmacologic e. Alternative medicine

23. What was a key limitation identified regarding the evidence base for nonpharmacologic treatments?

a. An abundance of high-quality studies. b. Consistent findings across all interventions. c. Insufficient evidence for certain conditions. d. Overwhelming support for all interventions studied. e. A lack of heterogeneity in study designs.

24. Which of the following assessment tools was NOT extensively used in the studies reviewed?

a. EPDS b. HAM-D c. GAD-7 d. PHQ-9 e. MMPI

25. The review explicitly defined perinatal mental health disorders using diagnostic tools/criteria in what proportion of the studies?

a. 27% b. 88% c. 55% d. 44% e. 38%

26. The studies included in this review predominantly assessed the effectiveness of nonpharmacologic treatments for which condition?

a. Anxiety disorders b. Post-traumatic stress disorder (PTSD) c. Combined anxiety and depressive disorders d. Depressive disorders e. Obsessive-compulsive disorder (OCD)

27. Which of the following is NOT a prioritized outcome measure extracted from the studies?

a. Depressive symptoms b. Anxiety symptoms c. Remission rates d. Blood pressure e. Response rates

Course Description

This course reviews the comparative effectiveness of nonpharmacologic treatments for perinatal mental health conditions and effectiveness of these treatments, such as depression, anxiety, PTSD, and OCD. Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) showed moderate evidence of reducing depressive symptoms compared to standard care, while exercise and behavioral activation also demonstrated benefits. Evidence on other interventions, including acupuncture and bright light therapy, was limited or inconclusive. Few studies addressed anxiety, PTSD, or OCD, with insufficient data to draw firm conclusions. The findings highlight a need for further research, especially on diverse treatment modalities and their impacts on broader mental health outcomes.

Learning Objectives

Describe key nonpharmacologic treatments for maternal mental health conditions, including depression, anxiety, and post-traumatic stress disorder.
Identify the strengths and limitations of the evidence base for nonpharmacologic treatments in addressing maternal mental health conditions during the perinatal period.
Outline the role of various assessment tools, such as the Edinburgh Postnatal Depression Scale (EPDS) and Hamilton Depression Rating Scale (HAM-D), in evaluating the effectiveness of nonpharmacologic interventions.

Source

Brown Evidence-based Practice Center Providence, RI

Investigators: Elyse Couch, Ph.D. Htun Ja Mai, M.B.B.S., M.P.H. Ghid Kanaan, M.D. Eduardo Caputo, Ph.D. Michael L. Zahradnik, M.Sc. Olivia Lewis, B.A. Lauren Bohlen, Ph.D. Margaret Howard, Ph.D. Gaelen P. Adam, Ph.D., M.L.I.S. Kristin J. Konnyu, Ph.D. Ethan M. Balk, M.D., M.P.H.

Social Workers