Efficacy of an Exercise Intervention for the Prevention of PostPartum Depression

描述（由申请人提供）：本申请是对PA-06-377“怀孕和产后妇女心理健康”的回应。“最近的估计表明，大约10- 15%的分娩妇女在产后期间经历抑郁症（Dietz等人，2007; Gaven等人，2005年）。研究表明，心理干预对治疗产后抑郁症是有效的（Dennis & Hodnett，2007）。然而，重要的是还要关注产后抑郁症的预防，因为许多妇女没有寻求治疗（Dennis & Chung-Lee，2006），而那些寻求治疗的妇女可能已经经历了与抑郁症相关的负面后果，包括停止母乳喂养和母婴关系不良（Dennis & McQueen，2007; Murray et al.，2007）。1999年）。不幸的是，研究表明，心理干预在预防产后抑郁症风险的妇女中并不有效（有关综述，请参见Dennis & Creedy，2004）。因此，有必要测试新的和创新的干预措施，以预防产后抑郁症。运动干预已被证明对治疗成年人抑郁症有效，因此，这种干预可能对预防产后抑郁症有效。本试点研究的目的是研究的可行性，招募和保留参与者的产后抑郁症的风险进行随机试验，检查运动干预预防产后抑郁症。我们亦会研究运动干预对预防产后抑郁症的初步成效。具体而言，将从各种妇产科诊所、精神科诊所和通过广告招募120名久坐不动的健康孕妇，这些孕妇至少有一次抑郁发作史和/或有母亲抑郁症家族史。一旦潜在的参与者收到医疗保健提供者同意行使（约。阴道分娩后两周和剖腹产后四周），参与者将被随机分配到运动干预或健康和健康接触控制条件。运动条件将包括基于电话的咨询会议，旨在激励产后妇女成为身体活跃。这种基于理论的干预措施将基于先前研究中证明有效的干预措施。接触控制条件将包括与健康教育者就与健康和保健有关的问题（例如，减压、睡眠、营养）。本研究的具体目的是：1）确定招募和保留孕妇和产后妇女进行运动干预试验的可行性; 2）确定基于家庭的行为运动干预对产后妇女抑郁症的影响（通过DSM-IV轴I障碍结构化临床访谈; SCID-I和PHQ-9测量）。将使用7天身体活动回忆访谈（Blair et al.，1985; Sallis等人，1985）和加速度计（即，对身体活动的客观评估）。公共卫生相关性：最近的估计表明，大约10- 15%的分娩妇女在产后期间经历抑郁症。本研究旨在探讨运动干预预防产后抑郁症的可行性和有效性。如果有效的话，我们的干预可以在“真实的世界环境”中传播，以预防产后抑郁症。

DESCRIPTION (provided by applicant): This application is in response to PA-06-377 "Women's Mental Health in Pregnancy and the Postpartum Period." Recent estimates indicate that approximately 10-15 percent of women giving birth experience depression during the postpartum period (Dietz et al., 2007; Gaven et al., 2005). Research indicates that psychological interventions are efficacious for treating postpartum depression (Dennis & Hodnett, 2007). However, it is important to also focus on the prevention of postpartum depression given many women do not seek treatment (Dennis & Chung- Lee, 2006) and those who do seek treatment may have already experienced negative consequences related to depression including cessation of breastfeeding and poor maternal-child bonding (Dennis & McQueen, 2007; Murray et al., 1999). Unfortunately, research indicates that psychological interventions are not efficacious in the prevention of postpartum depression among women at risk for postpartum depression (for a review see Dennis & Creedy, 2004). Consequently, there is a need to test new and innovative interventions for the prevention of postpartum depression. Exercise interventions have been shown to be effective for the treatment of depression among adults and therefore, this intervention may be efficacious in the prevention of postpartum depression. The purpose of the present pilot study is to examine the feasibility of recruiting and retaining participants at risk for postpartum depression for a randomized trial examining an exercise intervention for the prevention of postpartum depression. We will also examine the preliminary efficacy of the exercise intervention on the prevention of postpartum depression. Specifically, 120 sedentary, healthy pregnant women who have a history of at least one depressive episode and/or have a maternal family history of depression will be recruited from various ObGyn clinics, psychiatry clinics, and via advertisements. Once the potential participants receive healthcare provider consent to exercise (approx. two weeks following a vaginal delivery and four weeks following a c-section), participants will be randomly assigned to either an exercise intervention or a health and wellness contact control condition. The exercise condition will consist of telephone-based counseling sessions designed to motivate postpartum women to become physically active. This theory-based intervention will be based on interventions shown to be effective in previous studies. The contact control condition will consist of scheduled telephone sessions with a health educator on issues related to health and wellness (e.g., stress reduction, sleep, nutrition). The specific aims of the study will be 1) to determine the feasibility of recruiting and retaining pregnant and postpartum women for an exercise inter-vention trial and 2) to determine the effect of a home-based behavioral exercise intervention on depression (as measured by the Structured Clinical Interview for DSM-IV Axis I Disorders; SCID-I and the PHQ-9) among postpartum women. Physical activity adherence will be assessed using the 7-Day Physical Activity Recall Interview (Blair et al., 1985; Sallis et al., 1985) and accelerometers (i.e., an objective assessment of physical activity). PUBLIC HEALTH RELEVANCE: Recent estimates indicate that approximately 10-15 percent of women giving birth experience depression during the postpartum period. The purpose of this study is to examine the feasibility and efficacy of an exercise intervention for the prevention of postpartum depression. If efficacious, our intervention could be disseminated in "real world settings" in an effort to prevent postpartum depression.