Postpartum Depression
Conditions
Brief summary
Maternal depression and mother-infant relationship dysfunction have reciprocal effects on each other. An integrated approach addressing both problems simultaneously may improve outcomes. Perinatal Dyadic Psychotherapy (PDP) was developed to prevent/decrease postpartum depression and facilitate optimal mother-infant relationships. The purpose of this pilot study is to determine the feasibility, acceptability, and preliminary efficacy of PDP. Depressed first-time mothers (meeting diagnostic criteria for depression and/or with high depression symptom levels) and their 6-week-old infants will be randomized to receive either the PDP intervention or a control condition. The PDP intervention consists of 8 home-based, nurse-delivered mother-infant sessions consisting of (a) a supportive, relationship-based, mother-infant psychotherapeutic component, and (b) a developmentally based infant-oriented component focused on promoting positive mother-infant interactions. Control mothers will receive usual care plus depression monitoring by phone. Data will be collected at baseline, post-intervention, and 3 month follow-up. Assessments included maternal depression (diagnosis and severity), maternal anxiety (diagnosis and severity), parenting stress, and mother-infant interaction.
Interventions
BEHAVIORALPerinatal Dyadic Psychotherapy
8-session mother-infant psychotherapy (Perinatal Dyadic Psychotherapy) delivered by nurse-interventionists in participant's homes over 3 months
BEHAVIORALPlacebo Comparator
Standard care plus depression monitoring by phone
Sponsors
Robert Wood Johnson Foundation
Spaulding Rehabilitation Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* First-time, English-speaking mothers of healthy singleton newborns * Positive screen (\> 10) on Edinburgh Postnatal Depression Scale
Exclusion criteria
* Suicidal ideation * Currently receiving depression treatment * Meets criteria for bipolar disorder and/or lifetime or current psychotic disorder
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change from baseline on maternal depression diagnosis immediately following the 3 month intervention and at 3 months post-intervention as measured by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) | baseline, 3 months (post-intervention) and 6 months (follow-up) |
| Change from baseline in maternal depressive symptom scores immediately following the 3 month intervention and at 3 months post-intervention as measured by the Edinburgh Postnatal Depression Scale | baseline, 3 months (post-intervention) and 6 months (follow-up) |
| Mother-infant interaction (videotaped and coded) immediately following the 3 month intervention and at 3 months post-intervention | 3 months (post-intervention) and 6 months (follow-up) |
Secondary
| Measure | Time frame |
|---|---|
| Change from baseline in maternal anxiety diagnosis immediately following the 3 month intervention and at 3 months post-intervention per Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) | baseline, 3 months (post-intervention) and 6 months (follow-up) |
| Maternal parenting stress immediately following the 3 month intervention and at 3 months post-intervention as measured by the Parenting Stress Index - Short Form (PSI-SF) | 3 months (post-intervention) and 6 months (follow-up) |
| Change from baseline in maternal anxiety symptom level immediately following the 3 month intervention and at 3 months post-intervention as measured by the State-Trait Anxiety Inventory - State (STAI-State) | baseline, 3 months (post-intervention), 6 months (follow-up) |
Countries
United States
Outcome results
None listed