Antenatal Depression Clinical Trial
Official title:
Psychological Treatment Via the Internet for Antenatal Depression
Randomized controlled trial evaluating an Internet-delivered Cognitive Behavioral Therapy
(ICBT) adapted for pregnant women suffering from antenatal depression. The ICBT-program will
be added to treatment as usual (TAU) and compared to TAU only.
Participants (n=60) are recruited from all over Sweden (only Swedish citizens can
participate) and are assessed and treated on a distance via a secure web platform and
telephone.
In order to evaluate feasibility and effectiveness of an ICBT-program for antenatal
depression that will be used in a larger clinical trial, the current RCT (n=60) will be
performed and act as a pilot for the main study.
Participants will all be receiving the regular treatment (TAU) provided at their antenatal
clinic and other health care instances. Half of them will be randomized to an add-on of a
previously established 10-week long ICBT-program for depression in general, now adapted for
pregnant women. The other half will receive TAU during 10 weeks and then freely decide if
they want to participate in the pregnancy-adapted ICBT-program (only possible if 10 or more
weeks left till estimated delivery date), start the regular ICBT-program for depression
within 2-6 weeks post-partum, or decline ICBT-treatment. The participants in this study will
be recruited from all over Sweden via internet, advertisements and information at antenatal
clinics. A web-based screening questionnaire will form the basis for a first assessment and
review of inclusion criteria, followed by a structured telephone interview where diagnoses
(SCID-1 for depression, adjusted for DSM 5, and M.I.N.I. for other diagnoses and assessment
of suicide risk) and suitability will be assessed, a CGI-rating will be performed, and the
final decision on inclusion will be made.
Level of depression pre- and post-treatment will be assessed with MADRS-S filled out via the
internet-treatment platform together with the other self-rating measures used in the main
study. A questionnaire where the participants evaluate the content of the adapted
ICBT-program and their own use and perceived benefit of the treatment methods will also be
given at post-treatment and during treatment.
Structured telephone interview will be held at post-treatment, primarily to assess the
content of TAU, to administer CGI and a standardized version for MADRS-S (designed to
replace missing questionnaire data), and to make a qualitative evaluation of the
participants view of the adapted ICBT-program.
The estimated effect of ICBT compared to TAU is 0.8 (Cohen's d) and with 60 participants and
some attrition this will result in a statistical power of 80% for this initial, smaller RCT.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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