Health and Medical Psychology Clinical Psychology

The Effectiveness of Online Cognitive-Behavioral Therapy Combined with Healthy Lifestyle Education on Depression and Anxiety During Pregnancy in Women with Gestational Diabetes

https://doi.org/10.61838/ijbmc.v12i7.1026
Gestational diabetes Online cognitive-behavioral therapy Healthy lifestyle education Anxiety

Authors

  • Zahra Karimpour Aramaki Ph.D. Student, Department of Health Psychology, Payame Noor University, Tehran, Iran.
  • Ezzatollah Kordmirza Nikoozadeh
    Kordmirza@pnu.ac.ir
    Associate Professor, Department of Health Psychology, Psychology Department, Payame Noor University, Tehran, Iran.
  • Mojgan Aghaharis Associate Professor, Department of Psychology, Payame Noor University, Tehran, Iran.
  • Mahdieh Rahmanian Associate Professor, Department of Psychology, Payame Noor University, Tehran, Iran.
In Press
Quantitative Study(ies)

Objective: To determine whether an eight-week online cognitive-behavioral therapy (CBT) program integrated with healthy lifestyle education reduces depression and anxiety during pregnancy among women diagnosed with gestational diabetes mellitus (GDM).

Methods and Materials: In a randomized quasi-experimental design, 100 pregnant women with GDM were recruited purposively from a primary medical center in Qatar and randomly allocated to intervention (n=50) or control (n=50). The intervention comprised weekly online CBT sessions (cognitive restructuring, behavioral activation, stress-management, relaxation) plus lifestyle education (dietary guidance, physical activity, self-monitoring). The control group received routine prenatal care. Outcomes were assessed pre- and post-intervention with the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder-7 (GAD-7). Assumption checks included normality, homogeneity of variances, and covariance homogeneity. Group differences at posttest were examined using ANCOVA, adjusting for baseline scores; effect sizes were reported as partial eta squared.

Findings: Groups were comparable at baseline. Compared with controls, the intervention group showed greater reductions from pre- to post-test in depression and anxiety. For depression, the adjusted group effect was significant (F=111.4, p<0.001, η²=0.662), indicating a large effect. For anxiety, the adjusted group effect was also significant (F=23.5, p<0.001, η²=0.292), indicating a moderate effect. No intervention-related adverse events were reported, and session adherence was acceptable.

Conclusion: An eight-week online CBT program coupled with healthy lifestyle education produced clinically meaningful reductions in antenatal depression and anxiety among women with GDM. Integrating structured psychological support and lifestyle counseling into routine prenatal care may improve mental health in high-risk pregnancies. Multi-site trials with longer follow-up and metabolic endpoints are recommended.

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