- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04364646
Personalized Integrated Chronotherapy for Perinatal Depression
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The purpose of this research study is to collect data on whether adding light therapy and a prescribed sleep schedule to usual treatment for depression can reduce depression and anxiety symptoms during pregnancy and the postpartum. The study is enrolling pregnant woman between the ages of 18 and 40 who have been diagnosed with depression and (possibly) anxiety.
This study takes place from the 3rd trimester of pregnancy to 18 weeks postpartum. Women who take part in this study will be randomly assigned ("randomized") into one of the study treatment groups (1) the "usual care" group (UC); or (2) the group that receives bright light therapy and a prescribed sleep schedule, also called the "Personalized Integrated Chronotherapy" group (PIC). The usual care group will receive medications and/or talk therapy as decided by the woman and her doctor. Women in the integrated chronotherapy group will receive usual care (as above) and will also receive a bright light box to sit with every morning for up to 60 minutes as prescribed by the study doctor. Light will be delivered with a portable, broad-spectrum light box. Both groups will have their sleep and light levels monitored during 3rd trimester of pregnancy (weeks 28-40) and weeks 2-6 and 18 after the baby is born (postpartum weeks 2-6 and 18) Sleep monitoring takes place in the home using a small wrist activity monitor called an "actigraph." Participants will also be asked to provide three saliva sample sets over the course of the study to measure melatonin levels.
In addition to the "Personalized Integrated Chronotherapy" study treatment that will supplement the clinical care as described above, participants will be asked to come in for research study visits.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Katherine M Sharkey, MD, PhD
- Phone Number: 401-793-3497
- Email: katherine_sharkey@brown.edu
Study Locations
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New York
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Glen Oaks, New York, United States, 11004
- Recruiting
- Feinstein Institute for Medical Research
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North Carolina
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Chapel Hill, North Carolina, United States, 27599
- Recruiting
- University of North Carolina
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Contact:
- Samantha Meltzer-Brody, MD,MPH
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Rhode Island
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Providence, Rhode Island, United States, 02903
- Recruiting
- Rhode Island Hospital
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Contact:
- Katherine M Sharkey, MD, PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- pregnant women, ages 18-45 years with a HAMD score >=14 and a current DSM-5 diagnosis of major depressive disorder as determined with the Current Major Depression Module of the Structured Clinical Interview for DSM disorders (SCID-I/P)
Exclusion Criteria:
- active psychosis or suicidality contraindicating outpatient treatment as determined by the clinical judgement of the research team and as measured with the B/C module of the SCID-I/P and the Columbia-Suicide Severity Rating Scale
- bipolar disorder (because sleep restriction can increase risk of conversion to mania)
- seizure disorder (because sleep restriction can increase seizure risk)
- self report of frequent migraines/headaches precipitated by bright light or sleep deprivation
- preexisting eye/skin disorders contraindicating light therapy
- use of photosensitizing medications
- primary Axis I diagnosis other than MDD (e.g., anorexia nervosa, ADHD)
- high risk pregnancy (e.g., conditions requiring mandatory bed rest or complex medical regimens that will interfere with study participation or conditions where poor infant outcomes are anticipated)
- starting antidepressants in the 4 weeks prior to enrollment
- current employment as night shift worker
- Alcohol Use Disorders Identification Test (AUDIT) score > 8 and/or Drug Abuse Screening Test (DAST) > 1 indicating current alcohol or drug use disorders
- women whose infants will not be living in the home or who will have a nighttime caregiver
- Pittsburgh Sleep Quality Inventory (PSQI)190 < 5 (i.e., those who report no sleep complaints during 3rd trimester of pregnancy and for whom an intervention targeting sleep might not be indicated).
- women who do not speak and read English because PIC research instruments are only available in English at this time. If this RCT shows effectiveness, future work will examine effectiveness in women who speak and read languages other than English.
- Women who experience fetal loss or stillbirth, as well as mothers whose infants are born before 36 weeks' gestation or have NICU stays > 5 days, will be discontinued from the study but will continue to receive UC.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Usual Care
Women in the usual care group receive medications and/or talk therapy.
Sleep and light levels are monitored at home with wrist actigraphy during 3rd trimester of pregnancy (weeks 28-40) and weeks 2-6 and18 after the baby is born (postpartum weeks 2-6 and 18).
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Based on their baseline sleep-wake schedule and real-life constraints (work and other responsibilities), an initial sleep schedule is set that allows 7.5 hours of sleep and provides time for participants to sit in front of the morning bright light.
Other Names:
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Experimental: Personalize Integrated Chronotherapy
Women in the integrated chronotherapy group receive usual care (medications and/or talk therapy, as above) and also receive a bright light box to sit with every morning for up to 60 minutes as prescribed by the study doctor.
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Based on their baseline sleep-wake schedule and real-life constraints (work and other responsibilities), an initial sleep schedule is set that allows 7.5 hours of sleep and provides time for participants to sit in front of the morning bright light.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Depressive Symptoms
Time Frame: change from baseline at 33 weeks of gestation
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Score on the Hamilton Depression Rating Scale (range=0-54, higher scores indicate more depressive symptoms)
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change from baseline at 33 weeks of gestation
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Change in Depressive Symptoms
Time Frame: change from baseline at 36 weeks of gestation
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Score on the Hamilton Depression Rating Scale (range=0-54, higher scores indicate more depressive symptoms)
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change from baseline at 36 weeks of gestation
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Change in Depressive Symptoms
Time Frame: change from baseline at 2 weeks postpartum
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Score on the Hamilton Depression Rating Scale (range=0-54, higher scores indicate more depressive symptoms)
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change from baseline at 2 weeks postpartum
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Change in Depressive Symptoms
Time Frame: change from baseline at 6 weeks postpartum
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Score on the Hamilton Depression Rating Scale (range=0-54, higher scores indicate more depressive symptoms)
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change from baseline at 6 weeks postpartum
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Change in Depressive Symptoms
Time Frame: change from baseline at 18 weeks postpartum
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Score on the Hamilton Depression Rating Scale (range=0-54, higher scores indicate more depressive symptoms)
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change from baseline at 18 weeks postpartum
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Circadian Phase
Time Frame: change from baseline at 36 weeks pregnancy
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Time of salivary dim light melatonin onset (DLMO)
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change from baseline at 36 weeks pregnancy
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Change in Circadian Phase
Time Frame: change from baseline at 6 weeks postpartum
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Time of salivary dim light melatonin onset (DLMO)
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change from baseline at 6 weeks postpartum
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Change in Sleep Timing
Time Frame: change from baseline at 33 weeks of pregnancy
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time of sleep onset and sleep offset measured with wrist actigraphy
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change from baseline at 33 weeks of pregnancy
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Change in Sleep Timing
Time Frame: change from baseline at 36 weeks of pregnancy
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time of sleep onset and sleep offset measured with wrist actigraphy
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change from baseline at 36 weeks of pregnancy
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Change in Sleep Timing
Time Frame: change from baseline at 2 weeks postpartum
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time of sleep onset and sleep offset measured with wrist actigraphy
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change from baseline at 2 weeks postpartum
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Change in Sleep Timing
Time Frame: change from baseline at 6 weeks postpartum
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time of sleep onset and sleep offset measured with wrist actigraphy
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change from baseline at 6 weeks postpartum
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Change in Sleep Timing
Time Frame: change from baseline at 18 weeks postpartum
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time of sleep onset and sleep offset measured with wrist actigraphy
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change from baseline at 18 weeks postpartum
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Infant sleep behavior
Time Frame: 18 weeks postpartum
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infant sleep-wake patterns will be measured with one week of ankle actigraphy
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18 weeks postpartum
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Melatonin levels and timing of onset in breastmilk
Time Frame: 18 weeks postpartum
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We will examine associations between salivary melatonin levels and melatonin levels in breast milk
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18 weeks postpartum
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Kristina M Deligiannidis, MD, Northwell Health
- Principal Investigator: Samantha Meltzer-Brody, MD, University of North Carolina, Chapel Hill
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Behavioral Symptoms
- Mental Disorders
- Nervous System Diseases
- Mood Disorders
- Sleep Wake Disorders
- Pregnancy Complications
- Puerperal Disorders
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Depression
- Depressive Disorder
- Dyssomnias
- Parasomnias
- Depression, Postpartum
- Chronobiology Disorders
Other Study ID Numbers
- 18-0913
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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