Psychotherapy for Postpartum Depression

Overseen By Maddy Schier

Age: Any Age

Sex: Female

Trial Phase: Academic

Sponsor: Weill Medical College of Cornell University

Must be taking: Antidepressants

Must not be taking: Psychotropic drugs

Disqualifiers: Suicidal intent, Substance abuse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 9 weeks

60 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests a remote therapy called Engage & Connect for new mothers with postpartum depression. The therapy aims to reduce depression by encouraging social activities with significant others, helping mothers feel happier and less isolated.

Will I have to stop taking my current medications?

The trial requires that participants either be off antidepressants or on a stable dose for at least 8 weeks, with no plans to change the dose in the next 10 weeks. Other psychotropic drugs are generally not allowed, except for a small amount of lorazepam.

What data supports the effectiveness of the treatment Engage & Connect Psychotherapy for postpartum depression?

Research shows that psychotherapy, including interpersonal and mother-infant focused therapies, is effective in reducing symptoms of postpartum depression. These therapies improve mother-infant interactions and are considered safe for breastfeeding mothers, making them a recommended first-line treatment. ^{1 2 3 4 5}

Is psychotherapy safe for treating postpartum depression?

Psychotherapy is generally considered safe for treating postpartum depression, as it does not pose risks to breastfeeding infants and can be used as a first-line treatment without medication. ^{1 6 7 8 9}

What makes Engage & Connect Psychotherapy unique for treating postpartum depression?

Engage & Connect Psychotherapy is unique because it is a neuroscience-informed, streamlined approach specifically designed to address postpartum depression, focusing on enhancing interpersonal connections and emotional engagement, which are crucial during the transition to parenthood. ^{1 10 11 12 13}

Research Team

Nili Solomonov, PhD

Principal Investigator

Weill Medical College of Cornell University

Eligibility Criteria

This trial is for new mothers 4-12 weeks post-delivery who are experiencing postpartum depression, as indicated by a score of ≥10 on the Edinburgh Postnatal Depression Scale. Participants should be either off antidepressants or on a stable dose for at least 8 weeks and speak English well. Those with severe psychiatric conditions other than certain anxiety disorders or specific phobias, using certain psychotropic drugs, or undergoing ongoing psychotherapy are excluded.

Inclusion Criteria

Speaks English proficiently

You scored 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS).

I am able to understand and agree to the research and treatment plan.

Exclusion Criteria

I use no more than 0.5 mg of lorazepam daily or less.

You have a history of mental health conditions other than major depression, generalized anxiety, persistent depression, or specific phobias.

I am currently in psychotherapy, but not more than once every 8 weeks.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the Engage & Connect psychotherapy or Symptom Review and Psychoeducation intervention remotely over 9 weeks

9 weeks

Weekly remote sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Engage & Connect

Trial Overview The study is testing 'Engage & Connect,' a new type of psychotherapy designed to help reduce postpartum depression. It involves 9 weeks of remote therapy sessions aimed at decreasing feelings of social isolation and improving how social rewards are processed, along with measuring changes in the severity of depression.

Participant Groups

Group I: Symptom Review and Psychoeducation Experimental Treatment 1 Intervention

Group II: Engage & Connect Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

Weill Medical College of Cornell University

Lead Sponsor

Trials

1,103

Recruited

1,157,000+

Findings from Research

Psychotherapeutic interventions, particularly counseling, are effective as a standalone treatment for postpartum depression, making them a strong first-line option.

Unlike medication, psychotherapy poses no risks to breastfeeding infants, and there is emerging evidence that it may also help prevent postpartum depression, although further research is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The prevention and psychotherapeutic treatment of postpartum depression. Stuart, S., O'Hara, MW., Gorman, LL.[2016]

A group-based interpersonal psychotherapy (IPT) approach significantly reduced depression scores in 17 women diagnosed with postpartum depression, showing both immediate and lasting effects over a 6-month follow-up.

The study suggests that group IPT can be an effective treatment for postpartum depression, although limitations such as small sample size and lack of a control group may affect the reliability of the findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. Klier, CM., Muzik, M., Rosenblum, KL., et al.[2018]

Mother-infant interaction is crucial in treating postpartum depression, as infants are highly sensitive to their mothers' emotional states, which can significantly impact their development.

The paper discusses the need for tailored psychotherapeutic approaches for young mothers and presents an integrated treatment model that focuses on both the mother and infant to effectively address postpartum depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Psychotherapy for postpartum depression with a focus on mother-infant interaction]. Reck, C., Weiss, R., Fuchs, T., et al.[2018]

A pilot trial involving 16 postpartum couples showed that a family-based treatment for postpartum depression (PPD) was highly acceptable and feasible, with high session attendance and positive participant feedback.

Both mothers and fathers experienced improvements in depression symptoms and family functioning, suggesting that involving family members in PPD treatment could enhance outcomes and warrant further investigation in larger trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family treatment for postpartum depression: acceptability, feasibility, and preliminary clinical outcomes. Battle, CL., Cardemil, EV., Rossi, R., et al.[2023]

Both mother-infant psychotherapy and interpersonal psychotherapy significantly reduced maternal depressive symptoms compared to a waiting-list group, highlighting their efficacy in treating postpartum depression.

These therapies also improved mothers' perceptions of their infants and increased positive interactions, emphasizing the importance of early intervention for mothers experiencing major depression after childbirth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychotherapy for postpartum depression: a preliminary report. Clark, R., Tluczek, A., Wenzel, A.[2022]

An eight-week mindfulness-based cognitive therapy (MBCT) intervention showed promise as an adjunctive treatment for postpartum depression and anxiety, with participants experiencing significant decreases in their symptoms compared to a control group.

The study indicated that MBCT not only reduced depression and anxiety levels but also increased mindfulness, suggesting it could be a valuable non-pharmacological option for breastfeeding mothers who are hesitant to increase medication dosages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety. Shulman, B., Dueck, R., Ryan, D., et al.[2019]

This study will evaluate a blended cognitive-behavioral intervention for postpartum depression, combining face-to-face sessions with a web-based program, aiming to improve treatment accessibility for women who may not seek traditional help.

The trial will compare this blended intervention to usual care in healthcare centers, assessing various outcomes such as depressive symptoms, anxiety, and quality of life in Portuguese postpartum women, providing valuable data on its efficacy and cost-effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Blended Cognitive-Behavioral Intervention for the Treatment of Postpartum Depression: Study Protocol for a Randomized Controlled Trial. Branquinho, M., Canavarro, MC., Fonseca, A.[2021]

Postpartum depression affects 10% to 15% of new mothers, with even higher screening rates of 35% among African American women, highlighting the need for effective screening and intervention in primary care settings.

Effective treatments for perinatal depression include interpersonal psychotherapy and selective serotonin reuptake inhibitors, and timely mental health intervention can improve maternal well-being and prevent negative impacts on infant development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Antepartum and postpartum depression: healthy mom, healthy baby. Moses-Kolko, EL., Roth, EK.[2021]

A case study of a first-time mother with postpartum depression showed that therapist-assisted internet-delivered cognitive behavior therapy (ICBT) led to significant symptom reduction over 12 weeks, indicating its potential efficacy for treating PPD.

The participant reported high treatment satisfaction and a strong therapeutic alliance with her therapist, suggesting that this approach could be a valuable option for clinicians working with women experiencing PPD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet therapy for postpartum depression: a case illustration of emailed therapeutic assistance. Pugh, NE., Hadjistavropoulos, HD., Fuchs, CM.[2022]

Mother-infant psychotherapy has been shown to significantly reduce depressive symptoms in mothers in the short term, with a standardized mean difference of -0.25 based on 13 randomized controlled trials.

However, the therapy did not demonstrate long-term benefits for maternal mood, mother-infant interaction, or infant attachment, indicating that while it may help initially, further research is needed to understand its lasting effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The short- and long-term effectiveness of mother-infant psychotherapy on postpartum depression: A systematic review and meta-analysis. Huang, R., Yang, D., Lei, B., et al.[2020]

Interpersonal psychotherapy (IPT) has been shown to significantly improve symptoms of postpartum depression (PPD), with evidence from 11 clinical trials indicating overall clinical improvement and often full recovery in treated patients.

IPT can effectively shorten the time to recovery from PPD and help maintain longer periods of clinical remission, whether used alone or in combination with antidepressants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interpersonal psychotherapy for postpartum depression: a systematic review. Miniati, M., Callari, A., Calugi, S., et al.[2022]

Group Interpersonal Psychotherapy (IPT-G) is an effective, structured approach for treating postnatal depression (PND), focusing on the social and relational challenges faced by new mothers.

A randomized controlled trial supports the efficacy of IPT-G, highlighting its strengths in addressing attachment styles and social isolation during the transition to parenthood.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The development and content of an interpersonal psychotherapy group for postnatal depression. Reay, RE., Mulcahy, R., Wilkinson, RB., et al.[2012]

Interpersonal psychotherapy (IPT) is supported by strong evidence as an effective treatment for postpartum depression (PPD), focusing on the interpersonal challenges women face after childbirth.

IPT is delivered in 12 sessions and is particularly relevant for addressing issues like role transitions and interpersonal disputes, making it a practical and effective option for primary care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An approach to interpersonal psychotherapy for postpartum depression: focusing on interpersonal changes. Grigoriadis, S., Ravitz, P.[2022]

References

1. Austria pubmed.ncbi.nlm.nih.gov

The prevention and psychotherapeutic treatment of postpartum depression. [2016]

2. United States pubmed.ncbi.nlm.nih.gov

Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. [2018]

3. Germany pubmed.ncbi.nlm.nih.gov

[Psychotherapy for postpartum depression with a focus on mother-infant interaction]. [2018]

4. Austria pubmed.ncbi.nlm.nih.gov

Family treatment for postpartum depression: acceptability, feasibility, and preliminary clinical outcomes. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Psychotherapy for postpartum depression: a preliminary report. [2022]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety. [2019]

7. Switzerland pubmed.ncbi.nlm.nih.gov

A Blended Cognitive-Behavioral Intervention for the Treatment of Postpartum Depression: Study Protocol for a Randomized Controlled Trial. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Antepartum and postpartum depression: healthy mom, healthy baby. [2021]

9. Austria pubmed.ncbi.nlm.nih.gov

Internet therapy for postpartum depression: a case illustration of emailed therapeutic assistance. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

The short- and long-term effectiveness of mother-infant psychotherapy on postpartum depression: A systematic review and meta-analysis. [2020]

11. Austria pubmed.ncbi.nlm.nih.gov

Interpersonal psychotherapy for postpartum depression: a systematic review. [2022]

12. England pubmed.ncbi.nlm.nih.gov

The development and content of an interpersonal psychotherapy group for postnatal depression. [2012]

13. Canada pubmed.ncbi.nlm.nih.gov

An approach to interpersonal psychotherapy for postpartum depression: focusing on interpersonal changes. [2022]