Yuko Toshishige, Takuya Okami, Natsumi Chatani, Shiori Kawasaki, Shinobu Goto, Yuki Yoshida, Yusaku Takahashi, Misaki Shimasaki, Yousuke Miharu, Toshiaki A Furukawa, Hiroko Mizushima, Eizaburo Tanaka, Hiroko Maekawa, Tatsuo Akechi
The smartphone application was highly acceptable. While no significant differences in depressive symptoms were observed during pregnancy, differences favoring the intervention group were observed at 1 month postpartum. An IPT-informed smartphone intervention may represent a promising approach to perinatal mental health support.
BACKGROUND: Perinatal depression is a global health concern linked to adverse maternal and neonatal outcomes. Although evidence-based psychological interventions, such as interpersonal psychotherapy (IPT), are effective, women lack access to in-person perinatal care. Smartphone-based interventions may offer scalable support; however, evidence from randomized controlled trials (RCTs) evaluating IPT-informed smartphone interventions remains limited. This study assessed the acceptability and efficacy of an IPT-informed smartphone intervention for perinatal mental well-being.
METHODS: Participants were recruited nationwide through online advertisements and postcards. In this nonblinded RCT, 350 pregnant women were assigned to a fully self-guided smartphone application (intervention) or usual care (control). No minimum depression symptom score was required for participation. Acceptability in the intervention group at 8 weeks after enrolment was indicated by the Japanese version of the Client Satisfaction Questionnaire-8 (CSQ-8J) scores of ≥17. Efficacy was defined as the change in Patient Health Questionnaire-9 (PHQ-9) scores from baseline to 8 weeks following enrolment. Depressive symptoms were assessed at 1 month postpartum.
RESULTS: The application achieved acceptability, with 90.2% (157/174) of participants scoring ≥17 on the CSQ-8J. No significant between-group differences in depressive symptoms were observed during pregnancy (standardized mean difference (SMD) = 0.11). At 1 month postpartum, the intervention group exhibited significantly lower depressive symptom scores (SMD = 0.28).
CONCLUSIONS: The smartphone application was highly acceptable. While no significant differences in depressive symptoms were observed during pregnancy, differences favoring the intervention group were observed at 1 month postpartum. An IPT-informed smartphone intervention may represent a promising approach to perinatal mental health support.