Preventing Depressive Relapse in Pregnant Women With Recurrent Depression
Depression, Pregnancy Related, Antenatal Depression
About this trial
This is an interventional prevention trial for Depression focused on measuring Depression, Pregnancy, Antidepressants, Mindfulness, Medication use during pregnancy, Depression Relapse, Suicidal ideation
Eligibility Criteria
Inclusion Criteria:
- Pregnant women
- Ages 18 or older
- History of recurrent major depression prior to pregnancy (at least 2 prior episodes, one of which may be currently treated)
- Euthymic or with residual symptoms (PHQ-9 ≤ 9)
- No depressive relapse since last menstrual period
- Currently or recently received antidepressants (within the three months prior to last menstrual period)
- Presence of ongoing community provider
Exclusion Criteria:
- Diagnosis of bipolar or psychotic disorder
- Active mania, psychosis, or substance abuse (within the last 6 months)
- Immediate risk of self-harm
- Non-English speaking
Inclusion and exclusion criteria for the participants in the supplemental arms of the study differ from the main study and are as follows:
Arm 1 Aim 1a
Inclusion Criteria:
- Pregnant women (prior to 16 weeks gestation)
- Age 18 or older
- Presence of an ongoing community prescriber / provider
- Suicidal ideation as noted by item #9 of the PHQ-9
- History of recurrent depression, dysthymia or subsyndromal depression
Exclusion Criteria:
- Diagnosis of bipolar or psychotic disorder
- Mania, psychosis, or active substance abuse (within the last 6 months for substance abuse)
- Non-English speaking
Arm 1 Aim 1b
Inclusion Criteria:
- Age 18 or older
- Current prenatal healthcare provider of a participant enrolled in Arm 1 Aim 1a
Exclusion Criteria:
- Non-English speaking
Arm 1 Aim 1c
Inclusion Criteria:
- Pregnant women
- Age 18 or older
- Self-reported history of major depressive disorder
- Suicidal ideation as noted by item #9 of the PHQ-9
Exclusion Criteria:
- Non-English speaking
Arm 2
Inclusion Criteria:
- Pregnant women (prior to 16 weeks gestation)
- Age 18 or older
- History of recurrent major depression prior to pregnancy (at least two prior episodes, one of which may be currently treated)
- Euthymic or with residual symptoms (PHQ-9 </=9)
- Presence of an ongoing community prescriber / provider
- Current suicidal ideation as noted by item #9 of the PHQ-9 or past suicidal ideation as noted by item A3g on the MINI mood module
Exclusion Criteria:
- Diagnosis of bipolar or psychotic disorder
- Mania, psychosis, or active substance abuse (within the last 6 months for substance abuse)
- Non-English speaking
Sites / Locations
- University of Colorado Boulder
- Massachusetts General Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Digital delivery of MBCT (Mindful Mood Balance for Moms)
Usual Care
Subjects will receive digital delivery of mindfulness-based cognitive therapy (Mindful Mood Balance for Moms) for 12 weeks, along with the usual care they would receive from their provider.
Subjects will receive only usual care, the care they would normally receive from their community provider, for 12 weeks.