Acupuncture Treatment of Depression During Pregnancy

简介(取自申请人)：目的：建议的目的 随机对照研究是为了评估其疗效和疗效。 针灸治疗妊娠期抑郁症。意义：抑郁 不幸的是，在怀孕期间很常见，而且它有很大的害处 对母亲和婴儿的影响，包括低出生体重、早产、 并持续抑郁到产后。很少有医学上可以接受的治疗方法 可用于治疗妊娠期抑郁症。我们的 初步工作提供证据表明针灸可能是一种安全和 可接受的抑郁症治疗方案。具体目标：1)评估 专科针刺治疗重度抑郁症8周的疗效观察 在怀孕期间相对于两个对照处理；2)评估 继续治疗的疗效和临床意义(妊娠结局) 与两个对照治疗相比，采用特殊针灸；以及3) 评价专科针灸治疗重型颅脑损伤的疗效差异 产后抑郁对产后抑郁发生率的影响。与会者。设计：至 测试专为治疗抑郁症设计的针灸的疗效 妊娠期症状学(SPEC)将随机进行比较 分配给以下2个控制条件：1)有效针灸 不直接解决抑郁症状(NSPEC)，从而控制 对治疗效果的信念；以及2)产前按摩(MSSG)， 从而控制注意力、身体接触、放松和缓解 每天都有压力。研究分为急性期、延续期和随访期三个阶段。 向上。参与者：符合西方诊断标准的180名参与者 严重抑郁：24个条目中前17个条目的得分为14 汉密尔顿抑郁评定量表(HRSD)将被随机化。民族 样本的分布将代表民族分布 在旧金山湾区。治疗：治疗的急性期 包括16个半小时的治疗疗程，为期8周。至 巩固治疗成果，预防产后抑郁症， 在急性期结束时有完全或部分反应的参与者 将继续接受相同的治疗，但频率较低，直到10周 产后，并将再随访6个月。主要结果 测量(S)：主要结果测量是HRSD和抑郁症 SCID-IV的一部分，在治疗阶段每月给药 术后3个月和6个月随访。其他重要措施包括贝克 抑郁量表(每周)，(参与者和 服务提供者)，以及分娩和婴儿措施。

DESCRIPTION (TAKEN FROM APPLICANT): Objective: The aim of the proposed randomized controlled study is to assess the efficacy and effectiveness of acupuncture treatment of depression during pregnancy. Significance: Depression is, unfortunately common during pregnancy and it has significant deleterious effects on mother and infant, including low birth weight, preterm delivery, and continued depression into postpartum. Few medically acceptable treatments are available for the treatment of depression during pregnancy. Our preliminary work provides evidence that acupuncture may be a safe and acceptable treatment option for depression. Specific aims: 1) to evaluate the efficacy of brief 8-week treatment with SPEC acupuncture for major depression during pregnancy relative to the two control treatments; 2) to evaluate the efficacy and clinical significance (pregnancy outcome) of continued treatment with SPEC acupuncture relative to the two control treatments; and 3) to evaluate the differential impact of treatment with SPEC acupuncture for major depression on the incidence of postpartum depression. Participants. Design: To test the efficacy of acupuncture designed specifically to address depressive symptomatology during pregnancy (SPEC) it will be compared, using random assignment, to the following 2 control conditions: 1) valid acupuncture that does not directly address depressive symptoms (NSPEC), thus controlling for the belief in the efficacy of the treatment; and 2) prenatal massage (MSSG), thus controlling for attention, physical contact, relaxation and respite from daily stress. The study includes three phases, acute, continuation and follows up. Participants: 180 participants meeting western diagnostic criteria for Major Depression with a score >: 14 on the first 17 items of the 24-item Hamilton Depression Rating Scale (HRSD) will be randomized. The ethnic distribution of the sample will be representative of the ethnic distribution in the San Francisco Bay Area. Treatments: The acute phase of treatment consists of 16 half-hour treatment sessions delivered over 8 weeks. To consolidate treatment gains and to prevent post partum depression, participants who have full or partial response at the end of the acute phase will continue to receive the same, but less frequent, treatment until 10 weeks post partum, and will be followed up for 6 more months. Main Outcome Measure(s): The primary outcome measures are the HRSD and the depression portion of the SCID-IV, to be administered monthly during the treatment phases and at 3 and 6 months follow up. Other important measures include the Beck Depression Inventory (weekly), expectations (of the participants and the providers), and delivery and infant measures.