Antepartum Interpersonal Psychotherapy at 3 NYC Sites

纽约 3 个地点的产前人际心理治疗

• 批准号: 7124355
• 负责人: MARGARET Gail SPINELLI
• 金额: $ 54.7万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-21 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7124355
• 关键词: African American; Hispanic Americans; behavioral /social science research tag; caucasian American; clinical research; female; health education; human pregnant subject; human therapy evaluation; major depression; maternal behavior; mental disorder prevention; mother child interaction; multilingualism; patient oriented research; postpartum depression; pregnancy; prenatal care; psychological stressor; psychotherapy; racial /ethnic difference; socioeconomics; women' s health

DESCRIPTION (provided by applicant): The 10-13% prevalence of Antepartum Depression (APD) increases 2 fold in women with poor social supports, low socioeconomic status (SES) and negative life events. APD causes low birth weight, prematurity and eclampsia. APD is one of the best predictors of postpartum depression (PPD), which in turn causes impaired infant and childhood emotional and cognitive development. Therefore, treating APD is a method of primary and secondary prevention by treating parents of children at risk. Yet, there are no treatment guidelines for antepartum depression. This application is based on findings from a previous bilingual controlled clinical trial of Interpersonal Psychotherapy adapted for APD (IPT-P). The mood of the IPT-P treatment group significantly improved on all mood scores compared to a matched Parenting Education Program (PEP) control with the same duration, frequency and intensity of contact as the treatment group. This study sample was comprised of a majority of indigent Spanish speaking immigrant women with multiple psychosocial and financial stressors. Because of the small sample size, there was no information on the relationship of demographic variables such as race and SES to treatment feasibility, prognosis and attachment. Data from the National Comorbidity Study illustrated that effects of ethnicity and race must be examined in the context of SES and psychosocial variables in order to determine disparities in care and treatment outcome. In the proposed trial, a larger more diverse sample (N=150) of women from 3 different sites in New York City will provide enough power to generalize findings and determine the relationship of subgroup variables such as race/ethnicity and SES to treatment feasibility, motherhood and attachment. 3 sites (New York State Psychiatric Institute/New York Presbyterian Hospital at Columbia, New York Presbyterian Hospital at Cornell and St. Luke's Roosevelt hospital) will provide equal proportions of Latina, African American and White depressed pregnant women. Each subject will be randomized to 12 weeks of IPT-P or PEP, then followed for 6 months postpartum to determine if the IPT-P is more effective in reducing depression, preventing PPD and improving maternal infant attachment. Co-investigators are maternal fetal medicine faculty from respective sites who will be primary liaison to the respective departments of obstetrics and provide clinical obstetrical needs of the study.

描述（由申请人提供）：在社会支持较差、社会经济地位 (SES) 较低和消极生活事件的女性中，产前抑郁症 (APD) 的患病率为 10-13%，增加了 2 倍。 APD 会导致低出生体重、早产和子痫。 APD 是产后抑郁症 (PPD) 的最佳预测因子之一，而 PPD 反过来会导致婴儿和儿童情绪和认知发展受损。因此，治疗 APD 是通过治疗高危儿童的父母来进行一级和二级预防的方法。然而，目前还没有针对产前抑郁症的治疗指南。该应用程序基于之前针对 APD 的人际心理治疗 (IPT-P) 的双语对照临床试验的结果。与具有与治疗组相同的接触持续时间、频率和强度的匹配育儿教育计划 (PEP) 对照相比，IPT-P 治疗组的所有情绪评分均显着改善。本研究样本由大多数贫困的讲西班牙语的移民妇女组成，她们面临多种心理和经济压力。由于样本量较小，没有关于种族和社会经济地位等人口统计变量与治疗可行性、预后和依恋关系的信息。国家合并症研究的数据表明，必须在社会经济地位和心理社会变量的背景下审查民族和种族的影响，以确定护理和治疗结果的差异。在拟议的试验中，来自纽约市 3 个不同地点的更大规模、更多样化的女性样本 (N = 150) 将提供足够的力量来概括研究结果并确定亚组变量（例如种族/族裔和 SES）与治疗可行性的关系，母性和依恋。 3个地点（纽约州精神病学研究所/哥伦比亚长老会医院、康奈尔大学纽约长老会医院和圣卢克罗斯福医院）将提供同等比例的拉丁裔、非裔美国人和白人抑郁孕妇。每个受试者将被随机分配接受 12 周的 IPT-P 或 PEP，然后进行产后 6 个月的随访，以确定 IPT-P 是否在减少抑郁、预防 PPD 和改善母婴依恋方面更有效。共同研究者是来自各自地点的母胎医学教师，他们将作为各自产科的主要联络人，并提供研究的临床产科需求。