Effects of Interpersonal Psychotherapy on Depression During and After Pregnancy
Condition: Depression; Anxiety Disorders
MeSH terms: Depression; Depressive Disorder; Anxiety Disorders
Study type: Interventional

Summary: 
      This study will evaluate the impact of interpersonal psychotherapy on the course of
      depression during and after pregnancy, as well as its effect on infant birth outcomes.
    

Detailed description: 
      Depression is a serious illness that affects a person's body, mood, and thoughts. Researchers
      believe that it is one of the most common complications during and after pregnancy. The
      following symptoms may be signs of depression during pregnancy: 2 or more weeks of depressed
      mood; decreased interest or pleasure in activities; change in appetite or sleep patterns;
      fatigue or decreased energy; difficulty concentrating; excessive feelings of guilt or
      worthlessness; thoughts of suicide; and extreme restlessness or irritability. Depression is
      difficult to diagnose during pregnancy because its symptoms are sometimes confused with those
      of pregnancy. If left untreated, depression during pregnancy may affect not only the mother,
      but also the baby. Specifically, the hormone changes brought on by depression may contribute
      to premature and low-birth-weight infants. Interpersonal psychotherapy (IPT) is a short-term
      talking therapy that has been proven to be effective in treating depression. This study will
      evaluate the impact of interpersonal psychotherapy on the course of depression during and
      after pregnancy, as well as its effect on infant birth outcomes.

      This study is associated with a larger parent study. Participants in this open-label study
      may be recruited directly for this study or through the parent study. All participants will
      receive 16 sessions of IPT. Sessions will last approximately 50 minutes and will focus on
      achieving depression symptom remission by improving interpersonal functioning. The majority
      of IPT sessions will be held prior to delivery; up to four sessions may be held postpartum.
      No medication will be provided in this study, but women who are currently taking selective
      serotonin uptake inhibitors (SSRIs) at the time of study entry may continue taking their
      medication. Participants whose symptoms do not improve with IPT will be referred to their
      non-study physician for further evaluation, and may begin taking SSRI medication upon
      physician recommendation. The effects of both IPT and medication therapy will be considered
      when assessing outcomes. Study visits will occur at 28, 32, and 36 weeks gestation, as well
      as Weeks 1, 2, and 6, and Month 6 postpartum. Measurements will include cortisol levels,
      which will be obtained using a saliva sample, as well as depression symptom severity, which
      will be assessed at each IPT session. Blood samples will be taken as part of the parent
      study.
    

Intervention name(s): Interpersonal Psychotherapy (IPT)
Intervention type(s): Behavioral
Intervention description(s): IPT sessions will address adjustment to pregnancy, concerns about interpersonal relationships, and parenting concerns. Sessions will be weekly, but may be determined by clinical desires of patient and therapist.
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Pregnancy; Postpartum Depression