Developing a core outcome set for generalized anxiety disorder during the perinatal period: Identifying core treatment outcomes in perinatal anxiety

BACKGROUND: Generalized anxiety disorder during the perinatal period (pGAD) is highly prevalent and associated with adverse outcomes for both mother/birthing person (BP) and child. Yet, most treatment studies rely on researcher-selected outcomes that may not reflect patient priorities. OBJECTIVES: This study aimed to identify patient-oriented treatment outcomes for pGAD to inform the development of a core outcome set (COS). DESIGN: A qualitative study using focus groups was conducted in line with COMET and COREQ guidelines to capture patient perspectives on treatment outcomes. METHODS: Six semi-structured focus groups were conducted with participants who had a primary diagnosis of and participated in a cognitive behavioural therapy group for pGAD at the Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton. Discussions explored participants' experiences with perinatal anxiety, specifically which treatment outcomes were most important to them when seeking treatment for pGAD. Focus groups were audio-recorded, transcribed verbatim and analysed using thematic analysis with independent coding and consensus validation. RESULTS: A total of 21 participants (10 pregnant, 11 postpartum) were recruited. Three overarching themes were identified: (1) emotional well-being, (2) interpersonal and relational well-being and (3) daily functioning. Within these themes, the treatment outcomes most important to people with lived experience with pGAD were reported: increased self-awareness, management of distressing thoughts, partner relationship satisfaction, validation through support, improved sleep quality and overall quality of life. CONCLUSIONS: Patient-identified outcomes extend beyond symptom reduction and highlight the importance of psychological resilience, partner relationship satisfaction and functional recovery. Incorporating these outcomes into future treatment will enhance the relevance, comparability and clinical utility of interventions for pGAD, supporting the development of a patient-informed COS.