Considering Comorbidities and Individual Differences in Testing a Gaming Behavioral Activation App for Perinatal...

Area of Science:

• Digital mental health
• Perinatal mental health
• Behavioral activation

Background:

• Increasing demand for scalable digital mental health interventions in perinatal populations.
• Mobile behavioral activation (BA) is proven effective for perinatal depression.
• Comorbid anxiety and depression (CAD) impact symptom trajectories, affecting at least 10% of perinatal women.

Purpose of the Study:

• To compare symptom trajectories in pregnant individuals with CAD versus major depressive disorder (MDD) using a mobile BA app.
• To investigate the influence of comorbid conditions on treatment outcomes for perinatal depression.

Main Methods:

• Pregnant participants with CAD (n=10) or MDD (n=7) used a BA app for 10 weeks.
• Biweekly depression and anxiety symptom severity questionnaires were administered.
• Mixed-effects longitudinal models analyzed differential symptom trajectories based on baseline diagnoses.

Main Results:

• Depression symptoms significantly declined over time for both groups.
• Anxiety symptom trajectories differed: CAD group showed initial increase then accelerated decrease; MDD group showed stable anxiety.
• Individuals with MDD reported higher follow-up depression than those with CAD, controlling for baseline symptoms.

Conclusions:

• The BA app effectively reduced depression across different comorbidity profiles.
• Anxiety symptom reduction varied, with potential for enhanced effectiveness in the CAD group.
• Augmenting BA apps may be necessary to address anxiety symptoms in individuals with MDD.
• Considering comorbidities is crucial for developing effective perinatal digital mental health interventions.