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Preventing Depression in Pregnant Mothers Could Have Lasting Impact for Generations

Monday, November 11, 2019

Palo Alto University Professor Advocates for Global Approach to Preventing Depression  

Preventing depression in pregnant women or in women who have recently given birth (perinatal depression) may have long-lasting impact. In the Oct. 30 issue of Nature, noted depression prevention and treatment expert and Palo Alto University professor Ricardo Muñoz argues that offering women basic skills in mood management could have an impact across generations, because better maternal mental health is linked to healthier development in babies.

"I have been convinced of the importance of prevention in addressing mental-health problems since the early 1970s,” Muñoz says. “But only now is there sufficient evidence from clinical trials of the effectiveness of preventive interventions, using approaches derived from interpersonal and cognitive behavioral therapy, to justify deploying them.”

Two recent reports underline this conclusion. In February, the US Preventive Services Task Force, an independent panel of experts in evidence-based medicine, urged clinicians to “provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions”.

And last month, the US National Academies of Sciences, Engineering, and Medicine (NASEM) released a report calling on various stakeholders, from educators to policymakers, to prevent mental-health disorders and to promote healthy mental, emotional and behavioral development in women under 25. Munoz was a member of the committees that prepared this document and two previous NASEM reports   on preventive interventions.

Pregnant mothers are both an ideal population to work with, as well as one with far-reaching consequences, Muñoz says. The window of risk is discrete (during pregnancy and up to one year after childbirth); interventions can easily be included in prenatal classes or doctors’ visits; and outcomes would impact future generations since maternal depression is associated with low birthweight, preterm deliveries, and impaired cognitive development in the child.

In addition to calling for greater focus on the prevention of depression in mothers, Muñoz advocates for deploying technology to reach the greatest number women worldwide. Evidence-based preventive interventions could be made available to millions through ‘massive open online interventions’ or MOOIs — similar to ‘massive open online courses (MOOCs), which are delivered on the Internet for free. Such websites, apps and text-based interventions could also be useful for other high-risk groups such as adolescents. In his commentary piece, Muñoz lays out how MOOIs could work, based on his extensive work developing a course called Mothers and Babies/Mamás y Bebés while working at UCSF and Zuckerberg San Francisco General Hospital.

Globally available online tools to prevent depression and a focus on pregnant women could cut global depression in half, Muñoz maintains.  “We have the knowledge and the tools to create a world in which fewer people ever experience clinical depression and other mental disorders. Let’s start creating it.”

To read the Nature article, visit

Ricardo F. Muñoz is distinguished professor of clinical psychology and founding director of the Institute for International Internet Interventions for Health (i4Health) at Palo Alto University, California; and professor of psychology emeritus in the Department of Psychiatry at the University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, California, USA.

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