Randomized controlled trial of Sunnyside: Individual versus group-based online interventions to prevent postpartum depression

J Affect Disord. 2022 Aug 15;311:538-547. doi: 10.1016/j.jad.2022.05.123. Epub 2022 May 30.


Background: Postpartum depression (PPD) is a serious mental health problem that has a prevalence rate of nearly 20% in the first three months after delivery. The purpose of this study was to evaluate the benefit of Sunnyside, an internet-based cognitive-behavioral intervention, delivered in a group format compared to the same intervention delivered individually for the prevention of PPD.

Method: 210 people between 20- and 28-weeks gestation and who scored between 5 and 14 on the PHQ-8 and who did not meet criteria for major depression were recruited online. The Inventory of Depression and Anxiety Symptoms (IDAS), the Hamilton Rating Scale for Depression (HAMD), and the depression and anxiety modules of the MINI were obtained at baseline, post-treatment, and 12-weeks postpartum. Intervention adherence was measured by site usage.

Results: Across self-report and interview measures of depression there were no significant differences in outcome between the group and the individual versions of the program. Rates of major depression and generalized anxiety disorder in the postpartum period were low and adherence to the conditions was similarly high. Participants in the individual condition were significantly more satisfied than participants in the group condition (p < 0.05).

Limitations: The sample was predominantly white (85%) and recruited online, which may limit generalizability.

Conclusions: The group intervention was not more effective than the individual intervention. However, ignoring groups, many measures improved over time. The results of this study provide evidence that mood symptoms improve when participating in an online preventive intervention for postpartum depression.

Trial registration: ClinicalTrials.gov NCT02121015.

Keywords: Cognitive behavioral therapy; Internet; Postpartum depression; Prevention; Social support.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anxiety
  • Cognitive Behavioral Therapy* / methods
  • Depression
  • Depression, Postpartum* / prevention & control
  • Female
  • Humans
  • Internet
  • Internet-Based Intervention*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT02121015