Partner-Assisted Interpersonal Psychotherapy or Antidepressant Medication for Antenatal Depression
| Status: | Recruiting |
|---|---|
| Conditions: | Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 45 |
| Updated: | 1/1/2014 |
| Start Date: | November 2012 |
| End Date: | June 2016 |
Purpose: To compare a novel psychotherapy, Partner-Assisted Interpersonal Psychotherapy
(PA-IPT), with treatment as usual (TAU) in a sample of pregnant women seeking treatment for
Major Depressive Disorder (MDD) at the University of North Carolina at Chapel Hill (UNC-CH)
Perinatal Psychiatry Program.
Participants: 52 women, ages 18-45, who are 16-29 weeks pregnant and experiencing a
depressive episode, and their partners.
Methods: Women and their identified partners will complete a diagnostic interview, complete
measures of depressive symptom severity at baseline, and be randomized to treatment with
PA-IPT or TAU. Women randomized to TAU will be treated by UNC physicians according to the
UNC-CH Perinatal Psychiatry Program's algorithm for treatment of prenatal MDD (usually one
of a number of antidepressant medications, tailored to the individual, although some women
may opt against medication altogether and still be eligible to enroll). Women randomized to
PA-IPT will participate in 8 therapy sessions with their identified partner over a 12-week
period, along with one refresher session at or around 6 weeks postpartum. Women and
partners will be assessed for change in depressive symptoms and relationship satisfaction
during pregnancy at visits 4 and 8, and postpartum at 6-week and 6-month visits.
Hypothesis: The investigators anticipate notable improvement in both groups similar in
magnitude, however it is hypothesized that couples participating in PA-IPT will have higher
relationship satisfaction post-treatment (controlling for baseline satisfaction) than those
receiving TAU.
(PA-IPT), with treatment as usual (TAU) in a sample of pregnant women seeking treatment for
Major Depressive Disorder (MDD) at the University of North Carolina at Chapel Hill (UNC-CH)
Perinatal Psychiatry Program.
Participants: 52 women, ages 18-45, who are 16-29 weeks pregnant and experiencing a
depressive episode, and their partners.
Methods: Women and their identified partners will complete a diagnostic interview, complete
measures of depressive symptom severity at baseline, and be randomized to treatment with
PA-IPT or TAU. Women randomized to TAU will be treated by UNC physicians according to the
UNC-CH Perinatal Psychiatry Program's algorithm for treatment of prenatal MDD (usually one
of a number of antidepressant medications, tailored to the individual, although some women
may opt against medication altogether and still be eligible to enroll). Women randomized to
PA-IPT will participate in 8 therapy sessions with their identified partner over a 12-week
period, along with one refresher session at or around 6 weeks postpartum. Women and
partners will be assessed for change in depressive symptoms and relationship satisfaction
during pregnancy at visits 4 and 8, and postpartum at 6-week and 6-month visits.
Hypothesis: The investigators anticipate notable improvement in both groups similar in
magnitude, however it is hypothesized that couples participating in PA-IPT will have higher
relationship satisfaction post-treatment (controlling for baseline satisfaction) than those
receiving TAU.
Inclusion Criteria:
- Females aged 18-45 years
- 16-29 weeks estimated gestational age
- Able to provide informed consent
- English or Spanish language literacy
- In a committed relationship cohabiting for at least 6 months with a Dyadic Adjustment
Scale rating < 90 or with an identified family member or friend residing in the
same home
- Meet criteria for Diagnostic and Statistical Manual of Mental Disorders-Fourth
Edition Text Revision (DSM-IV) diagnosis of Major Depressive Disorder (MDD)
- HRSD-17 score is equal or greater than 16 at diagnostic evaluation and randomization
- Medically healthy and without fetal anomaly according to history
Exclusion Criteria:
- No identified primary care, nurse midwife, or obstetrical physician to monitor
pregnancy; participant or physician refuses to sign release of information
- By patient report, history of partner verbal, emotional, or physical abuse
- Partner unable or unwilling to participate
- DSM-IV diagnoses of bipolar 1 or 2 or any psychotic episode
- Substance abuse within the last 6 months
- Eating Disorder
- Current use of other therapies for depression including individual psychotherapy,
herbal remedies or other complementary/alternative therapies, antidepressant
medication outside the study protocol
- Active suicidal ideation
- Identified partner has DSM-IV diagnoses of bipolar 1 or 2 or any psychotic episode
- Interpersonal violence or abuse
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