ACUPUNCTURE TREATMENT OF DEPRESSION DURING PREGNANCY

因为很少有医学上可接受的治疗方法可用于 不幸的是，怀孕期间抑郁症的常见情况，我们的长期- 长期目标，以评估针灸的疗效和有效性 妊娠期抑郁症的治疗 作为第一步，这名飞行员 研究的重点是获得足够的数据，以完善试点设计 随后的随机临床试验。 妊娠期抑郁 具有显著的有害影响，包括低出生体重、早产 分娩，产后持续抑郁。 针灸 为抑郁症提供了另一种治疗方法（艾伦，Schnyer，和 Hitt，1998年），一种医学上可接受的，可能成为 怀孕期间理想的治疗选择。 我们的首要目标是 确定急性（短期）针灸治疗的疗效 怀孕期间的抑郁症是足够的保证， 大规模临床试验。 我们建议测试 针灸专门针对抑郁症， 妊娠期妇科检查与针灸治疗的比较 来解决不属于抑郁症状的有效症状 图片，从而控制的信念，在功效的 治疗 我们还建议比较特定的针灸产前 按摩，从而控制注意力，身体接触，放松 缓解日常压力 75名与会者会议 西方诊断标准的重性抑郁症将被随机分为 接受三种治疗中的一种，每种治疗包括12种治疗 在8周内交付的会议。因为患抑郁症的风险 以下交付是高，参与者谁拥有全部或部分 在急性期结束时的反应将继续收到相同的， 但频率较低，治疗至产后8周， 随访6个月以上。 具体目标是：（a）评估 针灸治疗的疗效（和效果大小）主要 抑郁症在怀孕期间的急性期结束时，相对于 两种对照条件; B）评价功效（和效果 大小）的组合急性/持续特定针灸对 产后抑郁症的发病率，相对于 两种对照条件;以及c）评价临床意义 针灸治疗抑郁症的研究， 治疗条件对婴儿结局的不同影响 措施 通过专注于这些目标，我们将能够实现 本PAS的以下既定目标：完善干预措施 战略，完善控制战略（包括我们的双 盲法），测试招聘程序的充分性，以及 制定有效措施。 此外，通过计算 流失率和效应量，我们将确定 参与者，最终将需要在一个明确的研究， 针灸治疗抑郁症的疗效和有效性 孕期

Because few medically acceptable treatments are available for the unfortunately common condition of depression during pregnancy, our long- term goal to assess the efficacy and effectiveness of acupuncture treatment of depression during pregnancy. As a first step, this pilot study focuses on obtaining sufficient data to refine the pilot design of a subsequent Randomized Clinical Trial. Depression during pregnancy has significant deleterious effects including low birth weight, preterm delivery, and continued depression into postpartum. Acupuncture provides an alternative treatment for depression (Allen, Schnyer, and Hitt, 1998), one that is medically acceptable and that could become an ideal treatment option during pregnancy. Our primary objective is to determine if the efficacy of acute (short term) acupuncture treatment for depression during pregnancy is substantial enough to warrant a large-scale clinical trial. We propose to test the efficacy of acupuncture designed specifically to address depressive that are not symptomatology during pregnancy by comparing it to acupuncture designed to address valid symptoms that are not part of the depressive symptom picture, thus controlling for the belief in the efficacy of the treatment. We also propose to compare specific acupuncture to prenatal massage, thus controlling for attention, physical contact, relaxation and respite from daily stress. Seventy five participants meeting western diagnostic criteria for Major Depression will be randomized to receive one of the three treatments, each consisting of 12 treatment sessions delivered over 8 weeks. Because the risk for depression following delivery is high, participants who have full or partial response at the end of acute phase will continue to receive the same, but less frequent, treatment until 8 weeks post partum, and will be followed up for 6 more months. The specific aims are: a) to evaluate the efficacy (and effect size) of acupuncture treatment for major depression during pregnancy at the end of the acute phase, relative to the two control conditions; b) to evaluate the efficacy (and effect size) of the combined acute/continuation specific acupuncture on the incidence of depression during the post partum period, relative to the two control conditions; and, c) to evaluate the clinical significance of acupuncture treatment for major depression by assessing the differential impact of the treatment conditions on infant outcomes measures. By focusing on these aims we will be able to meet the following stated objectives of this PAS: refine the intervention strategy, refine the control strategy (including success of our double- blind strategy), test the adequacy of recruitment procedures, and establish measures of effectiveness. In addition, by computing attrition rates and effect sizes we will determine the number of participants that will ultimately be needed in a definitive study of the efficacy and effectiveness of acupuncture in the treatment of depression during pregnancy.