Mindfulness online, with coaching support, prevented depression in pregnant women at risk
STUDY: Dimidjian S et al, Lancet Public Health 2026
STUDY TYPE: Randomized controlled trial
FUNDING: National Institutes of Health and National Institute of Mental Health
Background
Postpartum is a high-risk time for depressive relapse. Mindfulness-based therapy has robust preventative effects in depression, and this trial tested it through an online program that’s freely available to use.
The Study
- 500 pregnant women (about 11 weeks along) with recurrent major depressive disorder, currently well, and recently or currently on an antidepressant (70% still taking one).
- An 8-session online mindfulness-based cognitive therapy program over 12 weeks, with brief coaching, plus usual care, versus usual care alone.
- Follow-up ran to 6 months postpartum; 78% completed it.
- Primary outcomes: relapse by structured interview and the Depression scale (PHQ-9).
Results
Relapse occurred in 33% of the mindfulness group versus 44% with usual care (hazard ratio 0.74), a number needed to treat of about 9. The difference widened after delivery. The benefit held whether or not women were taking an antidepressant.
Depression scores improved more during the 12-week program, but the groups ended about the same. Stress was slightly lower with mindfulness.
Limitations
- Participants knew their assignment; only raters were blinded. Did not use an active comparison therapy.
- Most were white (85%) and college educated.
- Although the program is free to use, that doesn’t include the coaches employed in the study, who had advanced mental health training.
Practice Implications
- For pregnant patients with recurrent depression, consider this program alongside other treatments.
- Engagement makes a difference: women who finished all eight sessions did best, so check in about progress at prenatal visits.
- The program is available through the University of Colorado’s Crown Institute.
- Check my list of evidence based apps for more mindfulness programs.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
