Effects of Interpersonal Psychotherapy on Depression During and After Pregnancy
Effects of Interpersonal Psychotherapy on Depression During and After Pregnancy
This study will evaluate the impact of interpersonal psychotherapy on the course of
 depression during and after pregnancy, as well as its effect on infant birth outcomes.
Depression is a serious illness that affects a person's body, mood, and thoughts. Researchers
 believe that it is one of the most common complications during and after pregnancy. The
 following symptoms may be signs of depression during pregnancy: 2 or more weeks of depressed
 mood; decreased interest or pleasure in activities; change in appetite or sleep patterns;
 fatigue or decreased energy; difficulty concentrating; excessive feelings of guilt or
 worthlessness; thoughts of suicide; and extreme restlessness or irritability. Depression is
 difficult to diagnose during pregnancy because its symptoms are sometimes confused with those
 of pregnancy. If left untreated, depression during pregnancy may affect not only the mother,
 but also the baby. Specifically, the hormone changes brought on by depression may contribute
 to premature and low-birth-weight infants. Interpersonal psychotherapy (IPT) is a short-term
 talking therapy that has been proven to be effective in treating depression. This study will
 evaluate the impact of interpersonal psychotherapy on the course of depression during and
 after pregnancy, as well as its effect on infant birth outcomes.

 This study is associated with a larger parent study. Participants in this open-label study
 may be recruited directly for this study or through the parent study. All participants will
 receive 16 sessions of IPT. Sessions will last approximately 50 minutes and will focus on
 achieving depression symptom remission by improving interpersonal functioning. The majority
 of IPT sessions will be held prior to delivery; up to four sessions may be held postpartum.
 No medication will be provided in this study, but women who are currently taking selective
 serotonin uptake inhibitors (SSRIs) at the time of study entry may continue taking their
 medication. Participants whose symptoms do not improve with IPT will be referred to their
 non-study physician for further evaluation, and may begin taking SSRI medication upon
 physician recommendation. The effects of both IPT and medication therapy will be considered
 when assessing outcomes. Study visits will occur at 28, 32, and 36 weeks gestation, as well
 as Weeks 1, 2, and 6, and Month 6 postpartum. Measurements will include cortisol levels,
 which will be obtained using a saliva sample, as well as depression symptom severity, which
 will be assessed at each IPT session. Blood samples will be taken as part of the parent
 study.
Inclusion Criteria:

 -  No more than 28 weeks pregnant at the time of study entry

 -  History of depression or anxiety

 -  Current symptoms of distress

 -  Score of 9 or greater on the Edinburgh Postnatal Depression Scale (EPDS)

 -  English-speaking

 Exclusion Criteria:

 -  Plans to move away from the area prior to giving birth

 -  Current use of steroids for medical conditions