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2/2-Preventing Depressive Relapse in Pregnant Women with Recurrent Depression

2/2-预防复发性抑郁症孕妇的抑郁症复发

基本信息

批准号：
10223985
负责人：
LEE S COHEN
金额：
$ 40.08万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-23 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10223985
关键词：
Address Adult Algorithms Antidepressive Agents Attenuated Caring Characteristics Child Child Development Clinical Clinical assessments Cognitive Colorado Community Practice Compassion Decision Making Effectiveness Enrollment Exposure to General Hospitals Grant Health Personnel Intervention Investigation Maintenance Major Depressive Disorder Massachusetts Mediating Mental Depression Mental Health Monitor Mood Disorders Morbidity - disease rate Outcome Pharmacological Treatment Populations at Risk Postpartum Period Pregnancy Pregnant Women Prevention Provider Randomized Recording of previous events Recurrence Relapse Relative Risks Research Project Grants Risk Role Selection for Treatments Site Symptoms Testing Time Universities Woman Work aged base care providers clinical decision-making community setting data management depressive symptoms digital digital delivery disorder later incidence prevention interest mindfulness mindfulness based cognitive therapy practice setting pragmatic trial preference prenatal exposure prevent prospective randomized trial recruit recurrent depression reduce symptoms relapse prediction relapse risk reproductive standard of care theories tool treatment as usual treatment guidelines trial comparing

项目摘要

PROJECT ABSTRACT Depressive relapse during pregnancy is highly prevalent particularly among women with recurrent depression. Maternal psychiatric morbidity associated with depressive relapse during pregnancy is of concern as is the impact of untreated mood disorder during pregnancy and the postpartum period on child development. While maintenance antidepressant treatment is the standard of care for women with recurrent depression, concerns exist regarding known and unknown effects of fetal exposure to these agents; understandably, many pregnant women and their providers seek non-pharmacologic alternatives to pharmacologic treatment during pregnancy. Mindfulness-based cognitive therapy (MBCT) is efficacious in the prevention of depressive relapse among pregnant women as compared to usual care and is scalable using digital delivery. We propose a pragmatic effectiveness trial comparing MBCT to usual care (UC) among euthymic pregnant women (N=500) with recurrent depression treated with maintenance antidepressants. The study will be conducted at the University of Colorado Boulder (UCB; PI Dimidjian) and Massachusetts General Hospital (MGH; PI Cohen) using the Collaborative RO1 mechanism. This grant mechanism is justified given the unique expertise brought by each site to the proposed investigation. Specifically, the UCB site provides expertise in pragmatic randomized trials and MBCT for pregnant women, and the MGH site provides expertise in prospective monitoring of pregnant women with mood disorders. We will address three primary aims: 1) to examine the relative risk for depressive relapse and reduction of symptom burden between women randomized to digital MBCT or UC; 2) to examine the risk for depressive relapse between women who are randomized to MBCT who discontinue antidepressant treatment and those randomized to UC who discontinue antidepressant treatment, and to apply a treatment selection algorithm to ask what works for whom with respect to MBCT versus antidepressant maintenance; and 3) to examine the extent to which digital MBCT engages key putative targets. Systematic investigation of interventions that can attenuate risk for depressive relapse during pregnancy particularly in “at risk” populations minimizes the morbidity of recurrent depression during critical times in the lives of reproductive aged women.

项目摘要

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Challenge of Clinical Research and Suicidality: Participant Feedback on a Safety Protocol.

临床研究和自杀的挑战：参与者对安全方案的反馈。

DOI：
10.4088/jcp.22m14737
发表时间：
2023
期刊：
The Journal of clinical psychiatry
影响因子：
0
作者：
Vanderkruik,Rachel;Freeman,MarleneP;Dunn,KatherineA;Clifford,CharlotteA;Dimidjian,Sona;Cohen,LeeS
通讯作者：
Cohen,LeeS