Major Depressive Disorder Clinical Trial
Official title:
MBCT for Perinatal Women With Mood Disorders
This study will investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) for mood stabilization in perinatal women (preconception, pregnant, and postpartum) with a history of mood disorders. MBCT is a short-term group psychotherapy that has shown effectiveness in preventing depressive relapse. MBCT teaches mindfulness practices and cognitive-behavioral techniques.
Approximately 10-15% of women experience depression following the birth of a child.
Depression during pregnancy is also common. Women with a history of depression or bipolar
disorder are at increased risk of depressive relapse or exacerbation of mood symptoms during
the perinatal period. Perinatal depression is associated with a host of negative
consequences that can affect the mothers, infants, and families. Women with perinatal
depression may have trouble with parenting, marital quality, and employment. Children of
mothers with perinatal depression may suffer intellectually or emotionally. These children
are also more likely to develop a mood disorder or other psychiatric disorders throughout
their lifetimes compared to children whose mothers have not been depressed. Prevention
efforts during the preconception, pregnancy, and postpartum periods are of considerable
public health benefit. However, perinatal women are often reluctant to start or continue
psychotropic medications due to concerns about their influence on the developing fetus or
nursing infant. Therefore, psychosocial treatments that modify key vulnerability factors,
without medication side effects, are likely to be of strong interest to women who might
otherwise remain untreated.
This study will investigate the effectiveness of mindfulness-based cognitive therapy (MBCT)
for mood stabilization in perinatal women (preconception, pregnant, and postpartum) with a
history of mood disorders. MBCT is a short-term group psychotherapy that has shown
effectiveness in preventing depressive relapse. MBCT teaches mindfulness practices and
cognitive-behavioral techniques. Mindfulness is the practice of cultivating a non-judgmental
awareness of internal experiences (thoughts, feelings, and body sensations) and external
experiences. Cognitive-behavioral techniques focus on identifying maladaptive thoughts and
behaviors before they spiral into a depressive episode. MBCT teaches observational skills
and helpful techniques for responding to distorted or dysfunctional thoughts and behaviors,
thereby preventing an impending depressive relapse.
The investigators plan to (1) recruit 20 perinatal women at each of two sites with a history
of major depressive disorder or bipolar disorder (currently in remission or partial
remission), (2) ascertain their diagnoses and eligibility, (3) collect baseline data (e.g.,
demographic information, mood and anxiety symptoms), and (4) conduct open-trial MBCT groups
with 10-12 women in each group. The investigators examine the feasibility of identifying,
enrolling, and retaining perinatal women at high risk for mood episodes in an 8-week MBCT
group psychotherapy. Treatment effectiveness, acceptability, and satisfaction will be
assessed at the end of treatment, at 1 month post-treatment, and 6 months post-treatment.
This study will contribute to the field's understanding of non-pharmacological prevention
options for perinatal and postnatal women at risk for mood episode relapse. MBCT could fill
an urgently needed gap in services for preconception, pregnant, and postpartum women who are
at increased risk for relapse, and who wish to learn efficacious prevention skills. Given
the long-term adverse consequences of untreated perinatal mood episodes for women and their
children; low rates of treatment seeking; and concerns associated with pharmacological
treatments, the development of a viable psychosocial intervention may have significant
benefits for women, children, and society at large.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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