Psychoeducational preventive treatment for women at risk of postpartum depression: study protocol for a randomized controlled trial, PROGEA

Amaia Ugarte Ugarte, Purificación López-Peña, Carmen Serrulla Vangeneberg, Julia Gemma Torregaray Royo, Maria Asunción Arrieta Ugarte, Maria Teresa Zabalza Compains, Maria Pilar Riaño Medrano, Nerea Muñoz Toyos, Edurne Arenaza Lamo, Maria Begoña Beneitez Dueñas, Ana González-Pinto, Amaia Ugarte Ugarte, Purificación López-Peña, Carmen Serrulla Vangeneberg, Julia Gemma Torregaray Royo, Maria Asunción Arrieta Ugarte, Maria Teresa Zabalza Compains, Maria Pilar Riaño Medrano, Nerea Muñoz Toyos, Edurne Arenaza Lamo, Maria Begoña Beneitez Dueñas, Ana González-Pinto

Abstract

Background: Postpartum depression is a disease with a prevalence of 20% that has deleterious consequences not only for the mother but also for the baby and can cause delays in physical, social and cognitive development. In this context, the European Union Committee on Public Health has declared it essential that preventative measures are taken by centres providing care for women with a multidisciplinary approach. PROGEA is a multicentre, single-blind randomized, 3-year, longitudinal clinical trial aiming to evaluate the efficacy of a psychoeducational programme in preventing postpartum depression in at-risk women, based on a range of clinical variables, and explore prognostic factors. This paper describes the methods and rationale behind the study.

Methods: We will study women receiving treatment as usual plus a psychoeducation cognitive behavioural therapy (CBT)-based intervention and a control group receiving only treatment as usual. The sample will be recruited from an incidental sampling of pregnant women in two health regions. We will recruit 600 women in the third trimester of pregnancy who consent to take part in the study. Almost half of the women, about 280, would be expected to have some risk factors for postpartum depression. All those found to have risk factors will be evaluated, and we estimate that a quarter will be classified as at-risk of developing postpartum depression as measured with the Edinburgh Postnatal Depression Scale. This subset will be randomly allocated to receive treatment as usual with or without the CBT intervention. Six sessions of CBT (1 individual and 5 group) will be offered by a psychologist.

Discussion: Findings from this study will be used to design a definitive study that will examine the clinical and cost-effectiveness of the CBT-based intervention in improving the mood of women in the postpartum period.

Trial registration: ClinicalTrials.gov Identifier: NCT02323152 ; Date: December 2014.

Keywords: Cognitive Therapy; Depression; Depression, Postpartum; Motor Activity; Prevention and Control; Quality Of Life.

Figures

Fig. 1
Fig. 1
CONSORT diagram. The CONSORT diagram illustrates and reports the progression of the participants through the different points of the study

References

    1. mdg-report-2013-english.pdf [Internet]. [cited 2016 Mar 15]. Available from: . Accessed 2016.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders [Internet]. Fifth Edition. American Psychiatric Association; 2013 [cited 2016 Mar 15]. Available from: . Accessed 2016.
    1. Pearson RM, Evans J, Kounali D, Lewis G, Heron J, Ramchandani PG, et al. Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years. JAMA Psychiat. 2013;70:1312–9. doi: 10.1001/jamapsychiatry.2013.2163.
    1. Figueiredo FP, Parada AP, de Araujo LF, Silva WA, Jr, Del Ben CM. The Influence of genetic factors on peripartum depression: A systematic review. J Affect Disord. 2014;172C:265–73.
    1. Hoertel N, López S, Peyre H, Wall MM, González-Pinto A, Limosin F, et al. Are symptom features of depression during pregnancy, the postpartum period and outside the peripartum period distinct? Results from a nationally representative sample using item response theory (IRT) Depress Anxiety. 2015;32:129–40. doi: 10.1002/da.22334.
    1. Babb JA, Deligiannidis KM, Murgatroyd CA, Nephew BC. Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures. Behav Brain Res. 2015;276:32–44. doi: 10.1016/j.bbr.2014.03.039.
    1. Kingston D, Janes-Kelley S, Tyrrell J, Clark L, Hamza D, Holmes P, et al. An integrated web-based mental health intervention of assessment-referral-care to reduce stress, anxiety, and depression in hospitalized pregnant women with medically high-risk pregnancies: a feasibility study protocol of hospital-based implementation. JMIR Res Protoc. 2015;4:e9. doi: 10.2196/resprot.4037.
    1. Werner E, Miller M, Osborne LM, Kuzava S, Monk C. Preventing postpartum depression: review and recommendations. Arch Womens Ment Health. 2015;18:41–60. doi: 10.1007/s00737-014-0475-y.
    1. O’Connor E, Rossom RC, Henninger M, Groom HC, Burda BU. Primary care screening for and treatment of depression in pregnant and postpartum women: evidence report and systematic review for the us preventive services task force. JAMA. 2016;315:388–406. doi: 10.1001/jama.2015.18948.
    1. Pedersen C, Leserman J, Garcia N, Stansbury M, Meltzer-Brody S, Johnson J. Late pregnancy thyroid-binding globulin predicts perinatal depression. Psychoneuroendocrinology. 2016;65:84–93. doi: 10.1016/j.psyneuen.2015.12.010.
    1. Chojenta CL, Lucke JC, Forder PM, Loxton DJ. Maternal health factors as risks for postnatal depression: a prospective longitudinal study. PLoS ONE. 2016;11:e0147246. doi: 10.1371/journal.pone.0147246.
    1. Di Florio A, Forty L, Gordon-Smith K, Heron J, Jones L, Craddock N, et al. Perinatal episodes across the mood disorder spectrum. JAMA Psychiatry. 2013;70:168–75. doi: 10.1001/jamapsychiatry.2013.279.
    1. Gelabert E, Subirà S, Plaza A, Torres A, Navarro P, Imaz ML, et al. The Vulnerable Personality Style Questionnaire: psychometric properties in Spanish postpartum women. Arch Womens Ment Health. 2011;14:115–24. doi: 10.1007/s00737-010-0186-y.
    1. Bobes Bascarán MT, Jover M, Llácer B, Carot JM, Sanjuan J. Spanish adaptation of the EAS Temperament Survey for the assessment of child temperament. Psicothema. 2011;23:160–6.
    1. Alasoom LI, Koura MR. Predictors of postpartum depression in the eastern province capital of Saudi Arabia. J Fam Med Prim Care. 2014;3:146–50. doi: 10.4103/2249-4863.137654.
    1. Pilkington PD, Milne LC, Cairns KE, Lewis J, Whelan TA. Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis. J Affect Disord. 2015;178:165–80. doi: 10.1016/j.jad.2015.02.023.
    1. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord. 2016;191:62–77. doi: 10.1016/j.jad.2015.11.014.
    1. Blackmore ER, Côté-Arsenault D, Tang W, Glover V, Evans J, Golding J, et al. Previous prenatal loss as a predictor of perinatal depression and anxiety. Br J Psychiatry J Ment Sci. 2011;198:373–8. doi: 10.1192/bjp.bp.110.083105.
    1. Goyal D, Gay C, Lee KA. How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Womens Health Issues Off. Publ Jacobs Inst Womens Health. 2010;20:96–104.
    1. Cuijpers P, Andersson G, Donker T, van Straten A. Psychological treatment of depression: results of a series of meta-analyses. Nord J Psychiatry. 2011;65:354–64. doi: 10.3109/08039488.2011.596570.
    1. Brugha TS, Morrell CJ, Slade P, Walters SJ. Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care. Psychol Med. 2011;41:739–48. doi: 10.1017/S0033291710001467.
    1. Vega-Dienstmaier JM, Mazzotti Suárez G, Campos Sánchez M. Validation of a Spanish version of the Edinburgh postnatal depression scale. Actas Esp Psiquiatr. 2002;30:106–11.
    1. Sánchez Sánchez, Fernando, Fernandez Santamaria, Pablo, Fernández-Pinto, Irene, Arribas Águila,David. Merrill-Palmer-R Escalas de desarrollo [Internet]. Madrid: TEA Ediciones S.A.; 2011. Available from:
    1. Martínez-González MA, López-Fontana C, Varo JJ, Sánchez-Villegas A, Martinez JA. Validation of the Spanish version of the physical activity questionnaire used in the Nurses’ Health Study and the Health Professionals’ Follow-up Study. Public Health Nutr. 2005;8:920–7. doi: 10.1079/PHN2005745.
    1. World Health Organization. Global Physical Activity Questionnaire (GPAQ) [Internet]. Geneva; Available from: . Accessed 2016.
    1. World Medical Association World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4. doi: 10.1001/jama.2013.281053.
    1. Busquets LB, Marino AP. Cálculo del tamaño muestral (TM) con el programa Ene 2.0: manual del programa, documentación y ejemplos [Internet]. Gráficas Monterreina; 2005. Available from: . Accessed 2016.

Source: PubMed

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