RELAPSE AND PREDICTORS OF DEPRESSION IN PREGNANCY

该提案概述了多机构合作研究（R-10） 我们将在该项目中评估 有严重抑郁症史的女性， 在怀孕期间停止抗抑郁治疗。的 本次调查的主要目的是（1）确定是否 维持治疗的女性的复发率较低， 妊娠期间停止抗抑郁药治疗;（2）确定 妊娠期复发的临床和心理预测因素 谁维持或停止抗抑郁药;和（3）评估围产期 妊娠结局及其与抑郁症的关系 本研究的三个参与研究中心包括围产期 临床研究项目，马萨诸塞州 总医院，哈佛医学院（科恩医生）。妇女生活中心 和情绪障碍研究计划，加州大学洛杉矶分校（Altshirt博士），埃默里 大学医学院（斯托博士）。情绪正常的受试者 至少三个月，并且没有停用抗抑郁药 在怀孕前六周以上， 妊娠，并将从妊娠的前三个月开始纵向随访。 通过分娩怀孕。考虑到抑郁症的普遍性 越来越多的妇女在生育期间接受 抗抑郁药治疗，关键是要确定那些妇女谁 可以安全地停止抗抑郁药治疗， 怀孕以及那些特别容易复发的人。 这些亚组的划分为筛选女性提供了机会 “风险”复发，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.