BMC Psychiatry | |
Online cognitive behaviour training for the prevention of postnatal depression in at-risk mothers: a randomised controlled trial protocol | |
Anthony Bennett1  Kylie Bennett1  David Ellwood3  Helen Christensen2  Kathleen M Griffiths1  Bethany A Jones1  | |
[1] Centre for Mental Health Research, The Australian National University, Building 63 Eggleston Road, Acton ACT 0200, Australia;The Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia;School of Medicine, Gold Coast campus, Griffith University, QLD 4222, Australia | |
关键词: Randomised controlled trial; E-health; Cognitive behaviour therapy; Postpartum depression; Perinatal depression; Postnatal depression; | |
Others : 1123929 DOI : 10.1186/1471-244X-13-265 |
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received in 2012-07-11, accepted in 2013-09-30, 发布年份 2013 | |
【 摘 要 】
Background
Postnatal depression (PND) is the most common disorder of the puerperium with serious consequences for both mother and child if left untreated. While there are effective treatments, there are many barriers for new mothers needing to access them. Prevention strategies may offer a more acceptable means of addressing the problem. Internet interventions can help overcome some barriers to reducing the impact of PND. However, to date there are no published studies that investigate the efficacy of internet interventions for the prevention of PND.
Methods/Design
The proposed study is a two-arm double blind randomised controlled trial. 175 participants will be recruited in the immediate postnatal period at an Australian community hospital. Women who meet inclusion criteria (internet access, email address, telephone number, over 18, live birth, fluent English) will complete the Edinburgh Postnatal Depression Scale (EPDS). Those with a score above 9 will undertake the Structured Clinical Interview for DSM Disorders (SCID). Those with a clinical diagnosis of depression, or a lifetime diagnosis of bipolar disorder or psychosis on the SCID will be excluded. Following completion of the baseline battery women will be randomised using a computer-generated algorithm to either the intervention or control condition. The intervention will consist of 5 modules of automated, interactive cognitive behaviour training (CB training), completed weekly with email reminders. The control will replicate the level of contact participants experience with the intervention, but the content will be of a general health nature. Participants will complete questionnaires immediately post-intervention (6 weeks) and 3-, 6- and 12 months follow-up. There will also be a second SCID delivered via telephone at 6 months. We hypothesise that relative to the control group, the intervention group will show a greater reduction in postnatal distress on the EPDS (primary outcome measure). We also hypothesise that the intervention group will demonstrate lower levels of anxiety and stress and higher levels of parenting confidence than the control group following intervention and/or follow-up.
Discussion
The proposed study addresses a number of limitations of earlier trials.
Trial registration
Australia and New Zealand Clinical Trials Registers, ACTRN12609001032246.
【 授权许可】
2013 Jones et al.; licensee BioMed Central Ltd.
【 预 览 】
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20150216051704102.pdf | 270KB | download | |
Figure 1. | 55KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]American Psychiatric Association: Diagnostic and statistical manual of mental disorders, fourth edition, text revision edn. Washington, D.C.: American Psychiatric Association; 2000.
- [2]O’Hara M, Swain A: Rates and risks of postpartum depression: a meta-analysis. Int Rev Psychiatry 1996, 8:37-54.
- [3]Milgrom J, Westley DT, Gemmill AW: The mediating role of maternal responsiveness in some longer-term effects of postnatal depression on infant development. Infant Behav Dev 2004, 27:443-454.
- [4]Boath E, Bradley E, Henshaw C: Women’s views of antidepressants in the treatment of postnatal depression. J Psychosom Obstet Gynaecol 2004, 25(3–4):221-233.
- [5]Whitton A, Warner R, Appleby L: The pathway to care in post-natal depression: women’s attitudes to post-natal depression and its treatment. Br J Gen Pract 1996, 46:427-428.
- [6]Dennis C-L, Hodnett E: Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database Syst Rev 2007, 2007(4):CD006116.
- [7]Dennis C-L, Chung-Lee L: Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth 2006, 33(4):323-331.
- [8]Dennis C-L, Creedy D: Psychosocial and psychological interventions for preventing postpartum depression.[see comment]. Cochrane Database Syst Rev 2004, (4):CD001134.
- [9]Dennis C-L, Dowswell T: Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev 2013., 2CD001134
- [10]Chabrol H, Teissedre F, Saint-Jean M, Teisseyre N, Roge B, Mullet E: Prevention and treatment of post-partum depression: a controlled randomized study on women at risk. Psychol Med 2002, 32(6):1039-1047.
- [11]Austin MP, Frilingos M, Lumley J, Hadzi-Pavlovic D, Roncolato W, Acland S, Saint K, Segal N, Parker G: Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial. J Affect Disord 2008, 105(1–3):35-44.
- [12]Lara M, Navarro C, Navarrete L: Outcome results of a psycho-educational intervention in pregnancy to prevent PPD: a randomized control trial. J Affect Disord 2010, 122(2):109-117.
- [13]Le H-N, Perry DF, Stuart EA: Randomized controlled trial of a preventive intervention for perinatal depression in high-risk latinas. J Consult Clin Psychol 2011, 79(2):135-141.
- [14]Tandon SD, Perry DF, Mendelson T, Kemp K, Leis JA: Preventing pernatal depression in low-income home visitng clients: a randomized controlled trial. J Consult Clin Psychol 2011, 79(5):707-712.
- [15]Maloni J, Przeworski A, Damato E: Web recruitment and internet use and preferences reported by women with postpartum depression after pregnancy complications. Arch Psychiatr Nurs 2013, 27(2):90-95.
- [16]Australian Bureau of Statistics: Household use of information technology, Australia, 2010–2011. Canberra: Australian Bureau of Statistics; 2011. In. vol. cat. no 8146.0
- [17]Griffiths KM, Farrer L, Christensen H: The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials. Med J Aust 2010, 192(11 Suppl):S4-11.
- [18]Spek V, Nyklicek I, Smits N, Cuijpers P, Riper H, Keyzer J, Pop V: Internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years old: a randomized controlled clinical trial. Psychol Med 2007, 37(12):1797-1806.
- [19]Calear AL, Christensen H, Mackinnon A, Griffiths KM, O’Kearney R: The youthmood project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents. J Consult Clin Psychol 2009, 77(6):1021-1032.
- [20]Christensen H, Griffiths KM, Jorm AF: Delivering interventions for depression by using the internet: randomised controlled trial. BMJ 2004, 328(7434):265.
- [21]Munoz RF, Le H-N, Ippen CG, Diaz MA, Urizar GG Jr, Soto J, Mendelson T, Delucchi K, Lieberman AF: Prevention of postpartum depression in low-income women: development of the mamas y bebes/ mothers and babies course. Cognit Behav Pract 2007, 14(1):70-83.
- [22]Cho HJ, Kwon JH, Lee JL: Antenatal cognitive-behavioral therapy for prevention of postpartum depression: a pilot study. Yonsei Med J 2008, 49(4):553-562.
- [23]Armstrong KL, Fraser JA, Dadds MR, Morris J: A randomized, controlled trial of nurse home visiting to vulnerable families with newborns. J Paediatr Child Health 1999, 35(3):237-244.
- [24]O’Hara MW, Stuart S, Gorman LL, Wenzel A: Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 2000, 57(11):1039-1045.
- [25]Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression: development of the 10-item edinburgh postnatal depression scale. Br J Psychiatry 1987, 150(6):782-786.
- [26]Boyce P, Stubbs J, Todd A: The edinburgh postnatal depression scale: validation for an Australian sample. Aust N Z J Psychiatry 1993, 27(3):472-476.
- [27]Spek V, Nyklicek I, Cuijpers P, Pop V: Internet administration of the Edinburgh depression scale. J Affect Disord 2008, 106(3):301-305.
- [28]Lee DT, Yip AS, Chan SS, Tsui MH, Wong W, Chung TK: Postdelivery screening for postpartum depression. Psychosom Med 2003, 361(3):357.
- [29]Chabrol H, Teissedre F: Relation between Edinburgh postnatal depression scale scores at 2–3 days and 4–6 weeks postpartum. J Reprod Infant Psychol 2004, 22(1):33-39.
- [30]Matthey S, Henshaw C, Elliott S, Barnett B: Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale - implications for clinical and research practice. Arch Womens Ment Health 2006, 9:309-315.
- [31]Lovibond PF, Lovibond SH: The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther 1995, 33(3):335-343.
- [32]Lovibond SH, Lovibond PF: Manual for the depression anxiety stress scales. 2nd edition. Psychology Foundation: Sydney; 1995.
- [33]Miller RL, Pallant JF, Negri LM: Anxiety and stress in the postpartum: is there more to postnatal distress than depression? BMC Psychiatry 2006, 6:12. BioMed Central Full Text
- [34]Crncec R, Barnett B, Matthey S: Development of an instrument to assess perceived self-efficacy in the parents of infants. Res Nurs Health 2008, 31(5):442-453.
- [35]Zanarini MC, Skodol AE, Bender D, Dolan R, Sanislow C, Schaefer E, Morey LC, Grilo CM, Shea MT, McGlashan TH, et al.: The collaborative longitudinal personality disorders study: reliability of axis I and II diagnoses. J Pers Disord 2000, 14(4):291-299.
- [36]Skre I, Onstad S, Torgersen S, Kringlen E: High interrater reliability for the structured clinical interview for DSM-III-R axis I (SCID-I). Acta Psychiatr Scand 1991, 84(2):167-173.
- [37]Hajebi A, Motevalian A, Amin-Esmaeili M, Hefazi M, Radgoodarzi R, Rahimi-Movaghar A, Sharifi V: Telephone versus face-to-face administration of the structured clinical interview for diagnostic and statistical manual of mental disorders, fourth edition, for diagnosis of psychotic disorders. Compr Psychiatry 2012, 53(5):579-583.
- [38]Griffiths KM, Christensen H, Jorm AF: Predictors of depression stigma. BMC Psychiatry 2008, 8:25. BioMed Central Full Text
- [39]Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C: Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression. Br J Psychiatry 2004, 185:342-349.
- [40]Griffiths KM, Crisp D, Christensen H, Mackinnon AJ, Bennett K: The ANU WellBeing study: a protocol for a quasi-factorial randomised controlled trial of the effectiveness of an internet support group and an automated internet intervention for depression. BMC Psychiatry 2010, 10:20. BioMed Central Full Text
- [41]Dennis C-L: Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh postnatal depression scale? J Affect Disord 2004, 78(2):163-169.
- [42]Cox JL, Murray D, Chapman G: A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry 1993, 163(1):27-31.
- [43]Krueger C, Tian L: A comparison of the general linear mixed model and repeated measures ANOVA using a dataset with multiple missing data points. Biol Res Nurs 2004, 6(2):151-157.