RELAPSE AND PREDICTORS OF DEPRESSION IN PREGNANCY

该提案概述了多机构合作研究(R-10) 在这个项目中，我们将评估以下人群中怀孕复发的风险 有严重抑郁症病史的女性要么坚持要么 在怀孕期间停止抗抑郁治疗。这个 这项调查的主要目的是(1)确定 保持复发/复发率的女性比 在妊娠期停止抗抑郁治疗；(2)确定 孕期复发的临床和心理社会预测因素 维持或停用抗抑郁药物者；及(3)评估围产儿 妊娠结局及其与抑郁症状的关系。 本次调查的三个参与地点包括围产期 和生殖精神病学，马萨诸塞州临床研究计划 哈佛大学医学院综合医院(科恩博士)。妇女生活中心 和情绪障碍研究项目，加州大学洛杉矶分校(Altshuler博士)，埃默里 大学医学院(斯托博士)。一直心情愉悦的受试者 至少三个月，并且没有停止服用抗抑郁药 受孕前六周以上将在他们的早期进入 怀孕，从怀孕的前三个月开始纵向随访 通过分娩怀孕。鉴于严重抑郁症的盛行率 在生育期间，越来越多的妇女接受了 使用抗抑郁药物治疗，关键是要确定哪些女性 可能能够安全地停止抗抑郁药物治疗 怀孕以及特别容易复发的人也是如此。 这些亚组的划分提供了对妇女进行筛查的机会 “处于复发风险”，并允许周到的治疗计划。

This proposal outlines a Multi-Institutional Collaborative Research (R-10) Project in which we will evaluate the risk for relapse in pregnancy among women with a history of major depression who either maintain or discontinue antidepressant treatment around the time of conception. The primary aims of this investigation are (1) to establish whether relapse/recurrence rates are lower in women who maintain versus discontinue antidepressant treatment during pregnancy; (2) to identify clinical and psychosocial predictors of relapse during pregnancy in those who maintain or discontinue antidepressants; and (3) to assess perinatal outcome and its relationship to depressive symptomatology in pregnancy. The three participating sites for this investigation include the Perinatal and Reproductive Psychiatry, Clinical Research Program, Massachusetts General Hospital, Harvard Medical School (Dr. Cohen). Women's Life Center and Mood Disorders Research Program, UCLA (Dr. Altshuler), Emory University School of Medicine (Dr. Stowe). Subjects who have been euthymic for at least three months and who have not discontinued antidepressant more than six weeks prior to conception will be accessioned early in their pregnancy and will be followed longitudinally from the first trimester of pregnancy through delivery. Given the prevalence of major depression during the childbearing years and the growing numbers of women who receive treatment with antidepressants, it is crucial to identify those women who may be able to safely discontinue antidepressant treatment during pregnancy as well as those who are particularly vulnerable to relapse. Delineating of these subgroups provides an opportunity to screen for women "at risk" for relapse and allows for thoughtful treatment plan.