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: 7687898
• 负责人: Sona Dimidjian
• 金额: $ 24.37万
• 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/7687898
• 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; 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; Mental Health; Modeling; Modification; Mood Disorders; National Institute of Mental Health; Nurses; Outcome; Parenting behavior; Participant; Perception; Perinatal; Pharmaceutical Preparations; Pharmacotherapy; Phase; Postpartum Depression; Postpartum Period; Pregnancy; Pregnant Women; Prevention; Prevention approach; Preventive Intervention; Process; Provider; Public Health; Publishing; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; 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; Stress; Symptoms; Testing; Training; Woman; Work; Writing; Yoga; base; behavioral health; comparative efficacy; depression; depressive symptoms; design; disorder later incidence prevention; experience; group intervention; high risk; improved; improved functioning; indexing; innovation; interest; meetings; mindfulness; mindfulness based cognitive therapy; mindfulness meditation; novel; perinatal intervention; preference; prevent; primary outcome; programs; prophylactic; psychoeducation; public education; recurrent depression; response; satisfaction; secondary outcome; theories; therapy design; therapy development; treatment as usual; treatment strategy; 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）：本研究将调查的可行性，安全性，可接受性和初步疗效的一个简短的，小组干预，旨在防止围产期抑郁症（PD）。我们将开发和评估基于正念认知疗法（MBCT）的行为预防干预，该疗法已被发现可显著降低一般成人样本中复发性抑郁症的复发率，并与PD的预防高度相关。MBCT是非药物的，提供了一种替代传统的一对一的护理模式，是基于一个明确的概念和经验之间的关系，具体的干预策略和最强大的风险因素围产期抑郁症，即抑郁症的历史。该项目将包括3个阶段，在2个产科环境中实施：1）基于理论和实证研究（MBCT用于围产期抑郁症; MBCT-PD）的干预措施的概念化，2）制定和标准化MBCT-PD，以及3）试点测试其在预防有抑郁症病史的围产期妇女复发和复发方面的功效。第一阶段工作已经在进行中。在第2阶段，我们提出了一个开放试验，以开发MBCT-PD程序（N=20）。基于一个迭代过程，我们将最终确定一个参与者和专家知情的手册MBCT-PD是敏感和具体的发展因素与PD。在第3阶段，我们建议在一项初步随机对照试验中测试MBCT-PD，将MBCT-PD与治疗作为药物（TAU）进行比较（N=160）。我们将检验接受MBCT-PD的参与者与接受TAU的参与者相比将经历改善的抑郁结局的主要假设，包括检验复发/复发率的组间差异和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介导因子。最后，我们将培训和评估行为卫生保健提供者的能力，以管理MBCT-PD计划的保真度。鉴于未治疗的围产期抑郁症对妇女及其子女的负面和持久后果，寻求治疗的低比率，以及与药理学方法相关的问题，MBCT-PD的开发和正在进行的研究可能对妇女，儿童和整个社会都有显着的好处