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| Name | Class |
|---|---|
| Women and Infants Hospital of Rhode Island | OTHER |
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This study tests the efficacy of interpersonal psychotherapy (IPT) for major depression following perinatal loss (early and late fetal death and early neonatal death) in a sample of 274 women in Flint and Detroit, Michigan. The trial will be the first fully powered randomized trial of treatment for any psychiatric disorder following perinatal loss.
The goal of this study is to conduct a fully-powered randomized efficacy study of IPT for MDD following perinatal loss. Our perinatal-loss adapted group IPT will be compared to a standard depression intervention (CWD, also delivered in a group format) in a sample of 274 women experiencing MDD following perinatal loss. The proposed randomized controlled trial (RCT) will test the hypotheses that: (1) IPT for perinatal loss will result in reduced time to recovery from MDD (primary), depressive symptoms, and PTSD symptoms (secondary) relative to CWD; and that among women meeting criteria for PTSD, IPT will result in reduced time to recovery from PTSD; (2) IPT for perinatal loss will result in increased social support, social role functioning (including parental functioning for women with living children), and well-being, and decreased grief and fear of subsequent pregnancies, relative to CWD; and (3) social support and grief will mediate the effects of IPT on time to MDD recovery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interpersonal psychotherapy for major depression following perinatal loss | Experimental | Participants in the IPT condition will receive 12 group sessions and 2 individual (pre-group and 1-month booster) sessions as outlined in the manual The individual sessions prepare patients to use the group effectively, to keep group members focused on their treatment goals, and to maintain treatment gains. In addition, 3 of the 12 group sessions will invite women to include their partners or other support people to bolster the woman's social support system and to reduce conflicts over how to react to the loss. These sessions are important because relationship distress is common following perinatal loss. Our IPT intervention allows new women to enter the group every 4 weeks of the 12-week group. Group sessions are semi-structured, and each woman will cover the four group topics three times, approaching each topic from a different stage in the mourning process. |
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| Coping with Depression | Active Comparator | The Coping with Depression (CWD) course is a structured, manualized psycho-educational group treatment for MDD. The CWD course is based on social learning theory which posits that depression is associated with a decrease in pleasant and an increase in unpleasant person-environment interactions. The problems shown by depressed individuals are viewed as behavioral, with cognitive patterns that can be unlearned or relearned. Its effectiveness is comparable to other forms of psychotherapy in depression. The course content is cognitive-behavioral in nature and is designed to train skills that can be used in the alleviation of depression. The skill modules focus on relaxation, cognitive skills, and behavioral activation. As in the pilot trial, CWD will consist of an individual pregroup session, 12 group therapy sessions (allowing new women to enter every 4th session) and a 1-month individual booster session to provide an identical treatment dose as the experimental condition. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Interpersonal psychotherapy for major depression following perinatal loss | Behavioral | Participants in the IPT condition will receive 12 group sessions and 2 individual (pre-group and 1-month booster) sessions as outlined in the manual The individual sessions prepare patients to use the group effectively, to keep group members focused on their treatment goals, and to maintain treatment gains. In addition, 3 of the 12 group sessions will invite women to include their partners or other support people to bolster the woman's social support system and to reduce conflicts over how to react to the loss. These sessions are important because relationship distress is common following perinatal loss. Our IPT intervention allows new women to enter the group every 4 weeks of the 12-week group. Group sessions are semi-structured, and each woman will cover the four group topics three times, approaching each topic from a different stage in the mourning process. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to Major Depressive Disorder recovery | Assessed via the Longitudinal Interview Follow-up Evaluation (LIFE; lower is better) | censored at 28 weeks, the proposed study duration |
| Measure | Description | Time Frame |
|---|---|---|
| Depressive symptoms | Overall score on the Quick Inventory of Depressive Symptoms (QIDS; lower is better) | 8, 16, and 28 weeks after intake |
| PTSD symptoms | Life Events Checklist and PTSD Checklist for DSM-5 (LEC-PCL; lower is better) |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment acceptability | Client Satisfaction Questionnaire - Revised (CSQ-8-R; higher is better) | 16 weeks after intake |
Inclusion Criteria:
Exclusion Criteria:
Adult women
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| Name | Affiliation | Role |
|---|---|---|
| Jennifer E Johnson, PhD | Michigan State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Anywhere in the entire state of Michigan (treatment is virtual) | Flint | Michigan | 48502 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27003141 | Background | Johnson JE, Price AB, Kao JC, Fernandes K, Stout R, Gobin RL, Zlotnick C. Interpersonal psychotherapy (IPT) for major depression following perinatal loss: a pilot randomized controlled trial. Arch Womens Ment Health. 2016 Oct;19(5):845-59. doi: 10.1007/s00737-016-0625-5. Epub 2016 Mar 22. | |
| 35440458 | Derived | Johnson JE, Price AB, Sikorskii A, Key KD, Taylor B, Lamphere S, Huff C, Cinader M, Zlotnick C. Protocol for the Healing After Loss (HeAL) Study: a randomised controlled trial of interpersonal psychotherapy (IPT) for major depression following perinatal loss. BMJ Open. 2022 Apr 19;12(4):e057747. doi: 10.1136/bmjopen-2021-057747. |
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This project will meet NICHD's timelines and requirements for depositing relevant de-identified data into relevant national databases. This will be reflected in study consent forms. De-identified data will be also made available to qualified researchers upon request, on a compact disk (CD) or other electronic means compatible with our systems. The request will be evaluated by the Principal Investigator to ensure that it meets reasonable standards of scientific integrity.
Data sharing will occur on NIH-designated timelines.
Request needs to meet reasonable standards of scientific integrity, as judged by the Study Principal Investigator
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| ID | Term |
|---|---|
| D003865 | Depressive Disorder, Major |
| D003863 | Depression |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
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| ID | Term |
|---|---|
| D000079062 | Interpersonal Psychotherapy |
| D000097813 | Coping Skills |
| ID | Term |
|---|---|
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D001521 | Behavior Therapy |
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|
| Coping with Depression | Behavioral | The Coping with Depression (CWD) course is a structured, manualized psycho-educational group treatment for MDD. The CWD course is based on social learning theory which posits that depression is associated with a decrease in pleasant and an increase in unpleasant person-environment interactions. The problems shown by depressed individuals are viewed as behavioral, with cognitive patterns that can be unlearned or relearned. Its effectiveness is comparable to other forms of psychotherapy in depression. The course content is cognitive-behavioral in nature and is designed to train skills that can be used in the alleviation of depression. The skill modules focus on relaxation, cognitive skills, and behavioral activation. As in the pilot trial, CWD will consist of an individual pregroup session, 12 group therapy sessions (allowing new women to enter every 4th session) and a 1-month individual booster session to provide an identical treatment dose as the experimental condition. |
|
|
| 8, 16, and 28 weeks after intake |
| Time to PTSD recovery | Assessed via the Longitudinal Interval Follow-Up Evaluation (LIFE; lower is better) | censored at 28 weeks, the proposed study duration |
| Overall perceived social support | Overall score of the Multidimensional Scale of Perceived Social Support (higher is better) | 8, 16, and 28 weeks after intake |
| Dyadic social support (from partner or another important person) | Overall score of the Relationship Assessment Scale (higher is better) | 8, 16, and 28 weeks after intake |
| Social role functioning (including parental functioning) | Overall score of the Short version of the Social Adjustment Scale (SAS) - Self Report and parental functioning SAS subscale (lower is better) | 8, 16, and 28 weeks after intake |
| Well-being | Overall score of the NIH Neuro-Quality of Life scale for positive affect and well-being (higher is better) | 8, 16, and 28 weeks after intake |
| Grief symptoms | Overall score of the Perinatal Bereavement Grief Scale (lower is better) | 8, 16, and 28 weeks after intake |
| Complicated grief symptoms | Overall score of the Inventory of Complicated Grief (lower is better) | 8, 16, and 28 weeks after intake |
| Perceived deservingness of loss and guilt over loss | Loss Beliefs Scale (lower is better) | 8, 16, an 28 weeks after intake |
| Fear of subsequent pregnancies | Overall score of the Fear of subsequent pregnancies measure (lower is better) | 8, 16, and 28 weeks after intake |
| D001519 |
| Behavior |