Brief Behavioral Activation Therapy Reduces Suicidal Ideation in Perinatal Depression: JAMA
Doctors
A new study published in the Journal of American Medical Association showed that following 3 months of weekly short behavioral activation treatment, suicidal ideation was reduced by 80% in individuals with perinatal depression.
One of the main causes of mother postpartum mortality is suicide. Interventions based on evidence are required. Therefore, regardless of the physician or delivery method, this study was carried out to ascertain if the chance of endorsing suicidal ideation (SI) changed throughout a brief behavioural activation (BA) treatment for prenatal depression.
In providing BA, SUMMIT contrasted modes (telemedicine vs. in-person) and clinicians (nonspecialist vs. specialist). Enrolment took place between January 2020 and October 2023. The investigation was carried out at networks connected to universities in Toronto, Canada; Chapel Hill, North Carolina; and Chicago, Illinois. Adults with depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS] score ≥10) who were pregnant (≤36 weeks) or postpartum (4–30 weeks) were recruited. In November 2024, examinations of secondary data were carried out.
1,117 of the 1,230 pregnant and postpartum people who were enrolled in the trial finished at least one therapy session and submitted at least one week's worth of EPDS data. The mean (SD) age was 33.4 (4.9) years, and 264 (23.6%) of the 1117 people that were included supported SI during therapy.
With each extra treatment session, the odds of approving SI dropped by 25%, according to cumulative link mixed models (odds ratio [OR], 0.75; 95% CI, 0.58-0.96; P =.03). At 3 months after randomization, the chances of supporting SI were 80% lower than at any other point during treatment (OR, 0.20; 95% CI, 0.14-0.27; P <.001).
Neither the mode (telemedicine versus in-person) nor the kind of clinician (specialist versus nonspecialist) affected the likelihood of approving SI. Additionally, individuals were substantially more likely to express suicidal thoughts on the C-SSRS at the start of therapy than at any other time point, according to goodness-of-fit χ2 tests.
Overall, regardless of the practitioner or delivery method, the probability of supporting SI declined throughout a short BA psychotherapy for postpartum depression and most dramatically at 3 months post randomization, according to this secondary analysis of the SUMMIT noninferiority randomized clinical trial.
Source:
Kaliush, P. R., Molina, N. C., Berenbaum, T. S., Dennis, C.-L., Gaynes, B. N., Meltzer-Brody, S., Reyes-Rodríguez, M. L., Silver, R. K., Stuebe, A. M., Vigod, S. N., Schiller, C. E., & Singla, D. R. (2025). Behavioral activation for perinatal suicide ideation: Secondary analysis of a noninferiority randomized clinical trial. JAMA Psychiatry (Chicago, Ill.). https://doi.org/10.1001/jamapsychiatry.2025.2116
