Acupuncture Treatment of Depression During Pregnancy

描述（从申请人处获取）：目的：拟定的目的 随机对照研究是为了评估疗效和有效性 针灸治疗妊娠期抑郁症。显著性：抑郁 不幸的是，在怀孕期间很常见， 对母亲和婴儿的影响，包括低出生体重、早产， 产后抑郁症一直持续到产后几乎没有医学上可接受的治疗 可用于治疗怀孕期间的抑郁症。我们 初步工作提供了证据，针灸可能是一种安全， 可以接受的治疗方案具体目标：（1）评估 针刺治疗抑郁症8周疗效观察 妊娠期间相对于两种对照治疗; 2）评估 继续治疗的疗效和临床意义（妊娠结局） 与两种对照治疗相比， 评价SPEC针灸治疗对主要 抑郁症对产后抑郁症的发病率有影响。参与者设计：为了 测试专门针对抑郁症的针灸疗效 妊娠期流产（SPEC），将使用随机 分配给以下2个对照条件：1）有效的针灸， 不直接解决抑郁症状（NSPEC），从而控制 对治疗效果的信念; 2）产前按摩（MSSG）， 从而控制注意力，身体接触，放松和喘息， 日常压力本研究包括急性期、持续期和随访期三个阶段 起来参与者：180名符合西方诊断标准的参与者， 重度抑郁症，24项中的前17项得分>：14 汉密尔顿抑郁评定量表（HRSD）将被随机化。民族 样本的分布将代表种族分布 在旧金山弗朗西斯科湾区。治疗：急性期治疗 包括在8周内提供的16个半小时的治疗疗程。到 巩固治疗成果，预防产后抑郁症， 急性期结束时完全或部分缓解的受试者 将继续接受相同但频率较低的治疗，直至10周 产后随访6个月。主要观察 测量：主要结局测量是HRSD和抑郁 SCID-IV的一部分，在治疗阶段每月给药一次 以及3个月和6个月随访时。其他重要措施包括贝克 抑郁量表（每周），期望（参与者和 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.