Mindfulness-Based Cognitive Therapy for the Prevention of Perinatal Depression

基于正念的认知疗法预防围产期抑郁症

• 批准号: 7510773
• 负责人: Sona Dimidjian
• 金额: $ 23.61万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-17 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7510773
• 关键词: Accounting; Address; Adherence; Adopted; Adult; Adverse effects; Adverse event; Agreement; Antidepressive Agents; Anxiety; Audiotape; Behavior Therapy; Behavioral; Belief; Caring; Characteristics; Child; Clinical; Cognitive; Colorado; Consensus; Consultations; Development; Developmental Process; Diagnostic; Discipline of obstetrics; Disease; Education; Empirical Research; Enrollment; Feedback; Fetus; Goals; Health Personnel; Health Services; High Risk Woman; Housing; Infant; Instruction; Intervention; Investigation; Literature; Location; Major Depressive Disorder; Manuals; Measures; Mediator of activation protein; Medical; Meditation; Mental Depression; Mental Health; Modeling; Modification; Mood Disorders; National Institute of Mental Health; Numbers; Nurses; Outcome; Parenting behavior; Participant; Perception; Perinatal; Personal Satisfaction; Pharmaceutical Preparations; Pharmacotherapy; Phase; Postpartum Depression; Postpartum Period; Pregnancy; Pregnant Women; Prevention; Prevention approach; Prevention intervention; Preventive Intervention; Process; Provider; Public Health; Publishing; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Range; Rate; Recording of previous events; Recurrence; Relapse; Reporting; Research; Research Project Grants; Risk; Risk Factors; Safety; Sampling; Science; Screening procedure; Self Efficacy; Services; Severities; Site; Societies; Standards of Weights and Measures; Stress; Symptoms; Testing; Training; USA Georgia; Week; Western Asia Georgia; Woman; Work; Writing; Yoga; base; behavioral health; depressive symptoms; design; experience; improved; improved functioning; indexing; innovation; interest; mindfulness based cognitive therapy; novel; perinatal intervention; preference; prevent; programs; prophylactic; psychoeducation; recurrent depression; response; satisfaction; theories; therapy design; therapy development; trial comparing

DESCRIPTION (provided by applicant): This study will investigate the feasibility, safety, acceptability, and preliminary efficacy of a brief, group intervention designed to prevent perinatal depression (PD). We will develop and evaluate a behavioral preventive intervention based on Mindfulness-Based Cognitive Therapy (MBCT), which has been found to significantly reduce rates of relapse of recurrent depression among general adult samples and has high relevance to the prevention of PD. MBCT is non-pharmacological, offers an alternative to traditional one-on-one care models, and is based on a clear conceptual and empirical relationship between the specific intervention strategies and the most robust risk factor for perinatal depression, namely depressive history. The project will involve 3 phases, implemented in 2 obstetric settings: 1) conceptualizing the intervention based on theory and empirical research (MBCT for perinatal depression; MBCT-PD), 2) developing and standardizing MBCT-PD, and 3) pilot testing its efficacy in preventing relapse and recurrence among perinatal women with histories of depression. Phase 1 work is already under way. In Phase 2, we propose an open-trial to develop the MBCT-PD program (N=20). Based on an iterative process, we will finalize a participant- and expert informed manual for MBCT-PD that is sensitive and specific to the developmental factors associated with PD. In Phase 3, we propose to test MBCT-PD in a pilot randomized controlled trial comparing MBCT-PD to Treatment-as-Usual (TAU) (N=160). We will test the primary hypothesis that participants receiving MBCT-PD will experience improved depressive outcomes compared to participants receiving TAU, including testing group differences in rates of relapse/recurrence and exploring group differences in depressive symptom severity. We will also explore group differences in secondary outcomes, including anxiety and stress and obstetrical complications, and will explore potential moderators and mediators of depression outcomes. Finally, we will train and evaluate the ability of behavioral health care providers to administer the MBCT-PD program with fidelity. Given the negative and enduring consequences of untreated perinatal depression for women and their children, low rates of treatment seeking, and concerns associated with pharmacological approaches, the development and ongoing investigation of MBCT-PD may have significant benefits for women, children, and society at large

描述（由申请人提供）：本研究将探讨一种旨在预防围产期抑郁症（PD）的简短群体干预的可行性、安全性、可接受性和初步疗效。我们将开发和评估一种基于正念认知疗法（MBCT）的行为预防干预，该疗法已被发现可显著降低普通成人样本中复发性抑郁症的复发率，并与预防PD具有高度相关性。MBCT是非药物的，提供了传统一对一护理模式的替代方案，并且基于特定干预策略与围产期抑郁症最强大的危险因素（即抑郁史）之间明确的概念和经验关系。该项目将分为3个阶段，在2个产科机构实施：1)基于理论和实证研究的干预措施概念化（MBCT治疗围产期抑郁症；MBCT- pd）， 2)制定和规范MBCT- pd， 3)试点测试其预防有抑郁症病史的围产期妇女复发和复发的效果。第一阶段的工作已经开始。在第二阶段，我们建议进行开放式试验来开发MBCT-PD计划（N=20）。基于一个反复的过程，我们将最终确定一个参与者和专家知情的MBCT-PD手册，该手册对与PD相关的发展因素敏感且特异性。在第三阶段，我们建议在一项比较MBCT-PD与常规治疗（TAU）的随机对照试验中测试MBCT-PD （N=160）。我们将测试接受MBCT-PD治疗的参与者与接受TAU治疗的参与者相比抑郁结果改善的主要假设，包括测试复发/复发率的组间差异，以及探索抑郁症状严重程度的组间差异。我们还将探讨次要结局的组间差异，包括焦虑、压力和产科并发症，并将探讨抑郁结局的潜在调节因子和中介因子。最后，我们将培训和评估行为卫生保健提供者的能力，以忠实地管理MBCT-PD计划。鉴于围产期抑郁症未经治疗对妇女及其儿童的负面和持久的影响，寻求治疗的比例低，以及与药理方法相关的担忧，MBCT-PD的发展和正在进行的研究可能对妇女、儿童和整个社会都有显著的益处