Effect of exercise and wellness interventions on preventing postpartum depression

描述（由申请人提供）：我们的申请是对PA-09-174“妇女在怀孕和产后期间的心理健康”的回应。“大约10%到13%的妇女经历产后抑郁症（Banti等人，2011年，Gaynes等人，2005年）。心理干预对治疗产后抑郁症有效（Dennis & Hodnett，2009）;然而，预防产后抑郁症比治疗更可取。研究表明，大多数心理干预对预防产后抑郁症无效（Dennis & Creedy，2008），因此，需要测试新的和创新的预防策略。研究表明，运动对治疗成年人的抑郁症是有效的（例如，布卢门塔尔等人，2007; Mead et al，2009），运动可能是不愿意或不能使用传统治疗的产后妇女的理想干预措施。例如，研究表明，大多数母乳喂养的母亲不愿意使用抗抑郁药（Buist等人，2005;惠顿等人，1996年）。本研究的目的是检查运动和健康/支持干预预防产后抑郁症的有效性。具体而言，450名在怀孕前有抑郁症病史的久坐产后妇女（2至6周）将被随机分为三组：（1）基于电话的运动干预;（2）基于电话的健康/支持干预;或（3）常规护理。参与者将通过在线，电子邮件和印刷广告招募。我们将 在随机化前获得每例受试者的医疗保健提供者同意。运动干预将包括基于理论的电话干预，其在先前的研究中显示增加了产后妇女的运动（刘易斯等人，2011年）。健康/支持条件将与运动干预的时间表相同，并将涉及与健康相关的几个主题。主要因变量将是抑郁，通过DSM-IV轴I障碍结构化临床访谈（SCID-I）和爱丁堡产后抑郁量表（EPDS）测量。将使用七天身体活动回忆访谈（Blair等人，1985; Sallis等人，1985）和ActiGraph（即，加速度计）。 公共卫生相关性：这项研究的主要目的是检查运动是否可以预防产后抑郁症，产后抑郁症发生在10%到13%的分娩妇女中。目的是为从业者提供预防产后抑郁症的额外策略。如果医生有能力告诉他们的病人锻炼作为一种策略，以减少他们患产后抑郁症的风险，那么对产后抑郁症的影响可能会很大。

DESCRIPTION (provided by applicant): Our application is in response to PA-09-174 "Women's Mental Health in Pregnancy and the Postpartum Period." Approximately 10 to13 percent of women experience postpartum depression (Banti et al., 2011, Gaynes et al., 2005). Psychological interventions are efficacious for treating postpartum depression (Dennis & Hodnett, 2009); however, the prevention of postpartum depression is preferable to treatment. Research indicates that a majority of psychological interventions are not efficacious for preventing postpartum depression (Dennis & Creedy, 2008) and thus, there is a need to test new and innovative prevention strategies. Research indicates that exercise is efficacious for the treatment of depression among adults (e.g., Blumenthal et al., 2007; Mead et al, 2009) and exercise may be an ideal intervention for postpartum women who are not willing or able to use traditional treatments. For example, research indicates that a majority of breastfeeding mothers are reluctant to use antidepressants (Buist et al., 2005; Whitton et al., 1996). The purpose of this study is to examine the efficacy of exercise and wellness/support interventions for preventing postpartum depression. Specifically, 450 sedentary postpartum women (two to six weeks) with a history depression prior to pregnancy will be randomized to one of three groups: (1) telephone-based exercise intervention; (2) telephone-based wellness/support intervention; or (3) usual care. Participants will be recruited via online, email, and print advertisements. We will obtain healthcare provider consent for each participant prior to randomization. The exercise intervention will consist of a theory-based telephone intervention shown to increase exercise among postpartum women in a previous study (Lewis et al., 2011). The wellness/support condition will be on the same schedule as the exercise intervention and will address several topics related to wellness. The primary dependent variable will be depression as measured by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Edinburgh Postnatal Depression Scale (EPDS). Exercise adherence will be assessed using the Seven-Day Physical Activity Recall Interview (Blair et al., 1985; Sallis et al., 1985) and the ActiGraph (i.e, an accelerometer). PUBLIC HEALTH RELEVANCE: The primary purpose of this study is to examine if exercise prevents postpartum depression, which occurs in 10 to 13 percent of women giving birth. The goal is to provide practitioners with additional strategies for preventing postpartum depression. A significant impact on postpartum depression could be made if practitioners have the ability to tell their patients to exercise as a strategy to reduce their risk for postpartum depression.