Identification and Therapy of Postpartum Depression

产后抑郁症的识别和治疗

• 批准号: 7035439
• 负责人: KATHERINE L WISNER
• 金额: $ 64.37万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7035439
• 关键词: behavioral /social science research tag; clinical research; clinical trials; female; health economics; health services research tag; human subject; human therapy evaluation; interview; longitudinal human study; mental disorder diagnosis; mental health counseling; mental health education; mother /infant health care; mother child interaction; patient care management; patient care personnel relations; patient oriented research; postpartum depression; preference; telemedicine; women' s health

DESCRIPTION (provided by applicant): Depression during the perinatal period is a major public health concern. Postpartum depression (PPD) causes personal and family suffering at a time when adaptation to parenthood is critical. Successful interventions for treating depression in medical settings have been framed by a chronic disease management model. The key ingredient to success is a dedicated care manager who provides education and support to patients, actively coordinates care, and thereby improves treatment outcomes for patients. Compared to interventions in medical office settings, telephone care management positioned at the level of the health plan offers a systematic and efficient mechanism for ongoing treatment support of women with PPD, particularly in a geographically dispersed population. We propose to conduct a comprehensive project to improve treatment outcomes for depressed postpartum women through adaptation of the depression care management model used in primary care settings. The major components are: 1) depression screening in a population of postpartum women, 2) depression education for all who screen positive, 3) a diagnostic interview to evaluate for depressive disorders in women who score above and below a defined threshold on the screening instrument, 4) a randomized controlled trial of telephone-based care management intervention vs. usual care for depression, and, 5) longitudinal evaluation across the first year post-birth for depression and maternal and child public health outcomes. All women in this project will be eligible for mental health services through two health plans (Community Care Behavioral Health Organization and Highmark). Both serve Medicaid and commercial members. We plan to identify women with PPD (n=462) who agree to be randomly assigned to the depression care management intervention or a usual care group. They will be supported in making choices about depression treatment (after receiving education about options), encouraged to access their preferred treatment (through the direct discussion of barriers and solutions), counseled to comply with treatment recommendations, and assisted to problem-solve if failure to respond occurs. Both groups will have systematic evaluations at 3, 6, and 12 months post-birth. Outcomes include not only maternal depressive symptom levels but also functional and public health outcomes for mothers, families, and infants. We have developed a multi-disciplinary team with expertise in clinical research with depressed and minority women and health services to address these needs.

描述（由申请人提供）：围产期的抑郁症是一个主要的公共卫生问题。产后抑郁症（PPD）在适应父母身份至关重要的时候会导致个人和家庭苦难。慢性疾病管理模型已经构建了成功治疗医疗环境中抑郁症的干预措施。成功的关键要素是专门的护理经理，他为患者提供教育和支持，积极协调护理，从而改善患者的治疗结果。 与医疗办公室环境的干预措施相比，位于健康计划级别的电话护理管理提供了一种系统，有效的机制，可为患有PPD的妇女提供持续的治疗支持，尤其是在地理位置分散的人群中。 我们建议通过适应初级保健环境中使用的抑郁症护理管理模型来进行一个全面的项目，以改善产后抑郁症的治疗结果。主要组成部分是：1）在产后妇女中进行抑郁症筛查，2）筛查所有筛查阳性的人的抑郁症教育，3）诊断性访谈，评估妇女的抑郁症，这些妇女的抑郁症在筛查工具上的定义阈值高于定义的阈值以下，4）在基于抑郁症和抑郁症的抑郁症中，对抑郁症和抑郁症进行了抑郁症的临时评估，以及临时的5），以及临时的5），以及临时的5），以及临时的临床，以及5）较长的临床及其5）结果。该项目中的所有妇女都有资格通过两个健康计划（社区护理行为健康组织和Highmark）获得心理健康服务。都为医疗补助和商业成员提供服务。我们计划确定同意被随机分配到抑郁症护理管理干预措施或通常的护理小组的女性（n = 462）。他们将受到支持，以做出有关抑郁症治疗的选择（接受有关期权的教育后），鼓励他们获得首选的治疗（通过直接讨论障碍和解决方案），咨询以遵守治疗建议，并协助解决问题，以解决问题。两组将在出生后3、6和12个月进行系统评估。结果不仅包括母亲抑郁症状水平，还包括母亲，家庭和婴儿的功能和公共卫生结果。我们已经建立了一个具有临床研究专业知识的多学科团队，并具有沮丧和少数族裔妇女和卫生服务，以满足这些需求。