Therapy for Prenatal Depression:Maternal & Fetal Effects

产前抑郁症的治疗：母亲

• 批准号: 6858082
• 负责人: Catherine E Monk
• 金额: $ 21.74万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6858082
• 关键词: behavioral /social science research tag; child mental disorders; child psychology; clinical research; counseling; data collection methodology /evaluation; depression; early experience; group therapy; health services research tag; human pregnant subject; human therapy evaluation; interdisciplinary collaboration; interview; longitudinal human study; mental disorder prevention; mother child interaction; neuropsychology; outcomes research; postpartum depression; pregnancy; prenatal stress; psychopathology; psychotherapy; questionnaires; women' s health

DESCRIPTION (provided by applicant): Historically, an unsubstantiated view held that pregnancy was a protective factor against depression. Data now dramatically contradict this view. Approximately 10-15% of pregnant women are depressed, which puts them -- and their children ---at risk for the deleterious affects of postpartum depression. Moreover, new data indicate that prenatal depression also may adversely affect the child even before birth. Despite the high prevalence rates of prenatal depression and its negative consequences, few controlled studies have tested the efficacy of psychotherapy during pregnancy. None has examined the effects of successfully treated depression on the fetus and newborn. The goal of this application -- submitted under the NIMH R34 mechanism for exploratory intervention research -- is to determine if an intervention for prenatal depression can enhance women's pre- and postpartum moods and improve fetal and newborn functioning. Specifically, in a study of 80 depressed women randomly assigned to either of two treatment options and 40 psychiatrically-healthy pregnant women, we hypothesize that depressed pregnant women treated with a group version of Interpersonal Psychotherapy versus standard psychiatric care will result in: (a) improved prenatal mood, (b) less postpartum depression and (c) fetal and newborn neurobehavioral profiles similar to healthy women's offspring. In past work we have shown that fetuses of depressed women have altered heart rate responses suggestive of risk for future stress-based psychopathology. Women's mood will be assessed using standard rating scales. Fetal heart rate and movement will be assessed while women undergo a laboratory stressor. Newborn heart rate will be assessed during an orthostatic challenge. This study has the potential to alter the clinical approach to perinatal mood disorders by demonstrating that we can (1) prevent postpartum depression before it occurs and (2) positively influence the child's development by limiting their exposure to women's pre- and postpartum depression.

描述（由申请人提供）：历史上，一种未经证实的观点认为怀孕是预防抑郁症的保护因素。现在的数据与这一观点截然不同。大约 10-15% 的孕妇患有抑郁症，这使她们及其孩子面临产后抑郁症有害影响的风险。此外，新数据表明，产前抑郁症甚至在孩子出生前也可能对孩子产生不利影响。尽管产前抑郁症的患病率很高及其负面后果，但很少有对照研究测试怀孕期间心理治疗的功效。没有人研究过成功治疗抑郁症对胎儿和新生儿的影响。该申请是根据 NIMH R34 探索性干预研究机制提交的，其目的是确定产前抑郁症的干预措施是否可以增强女性产前和产后的情绪，并改善胎儿和新生儿的功能。具体来说，在一项随机分配到两种治疗方案中的 80 名抑郁症妇女和 40 名精神健康孕妇的研究中，我们假设接受团体版人际心理治疗与标准精神科治疗相比，抑郁症孕妇将导致：(a) 产前情绪改善，(b) 产后抑郁减少，(c) 胎儿和新生儿神经行为 特征与健康女性的后代相似。在过去的工作中，我们已经表明，抑郁女性的胎儿会改变心率反应，这表明未来存在基于压力的精神病理学风险。将使用标准评分量表评估女性的情绪。当女性接受实验室压力源时，将评估胎儿心率和胎动。将在直立挑战期间评估新生儿心率。这项研究有可能改变围产期情绪障碍的临床方法，因为我们证明我们可以（1）在产后抑郁症发生之前预防产后抑郁症，（2）通过限制女性产前和产后抑郁症的接触来积极影响孩子的发育。