ICBT for Antenatal Depression

NCT ID: NCT02366429

Last Updated: 2016-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2016-03-31

Brief Summary

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Randomized controlled trial evaluating an Internet-delivered Cognitive Behavioral Therapy (ICBT) adapted for pregnant women suffering from antenatal depression. The ICBT-program will be added to treatment as usual (TAU) and compared to TAU only.

Participants (n=60) are recruited from all over Sweden (only Swedish citizens can participate) and are assessed and treated on a distance via a secure web platform and telephone.

Detailed Description

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In order to evaluate feasibility and effectiveness of an ICBT-program for antenatal depression that will be used in a larger clinical trial, the current RCT (n=60) will be performed and act as a pilot for the main study.

Participants will all be receiving the regular treatment (TAU) provided at their antenatal clinic and other health care instances. Half of them will be randomized to an add-on of a previously established 10-week long ICBT-program for depression in general, now adapted for pregnant women. The other half will receive TAU during 10 weeks and then freely decide if they want to participate in the pregnancy-adapted ICBT-program (only possible if 10 or more weeks left till estimated delivery date), start the regular ICBT-program for depression within 2-6 weeks post-partum, or decline ICBT-treatment. The participants in this study will be recruited from all over Sweden via internet, advertisements and information at antenatal clinics. A web-based screening questionnaire will form the basis for a first assessment and review of inclusion criteria, followed by a structured telephone interview where diagnoses (SCID-1 for depression, adjusted for DSM 5, and M.I.N.I. for other diagnoses and assessment of suicide risk) and suitability will be assessed, a CGI-rating will be performed, and the final decision on inclusion will be made.

Level of depression pre- and post-treatment will be assessed with MADRS-S filled out via the internet-treatment platform together with the other self-rating measures used in the main study. A questionnaire where the participants evaluate the content of the adapted ICBT-program and their own use and perceived benefit of the treatment methods will also be given at post-treatment and during treatment.

Structured telephone interview will be held at post-treatment, primarily to assess the content of TAU, to administer CGI and a standardized version for MADRS-S (designed to replace missing questionnaire data), and to make a qualitative evaluation of the participants view of the adapted ICBT-program.

The estimated effect of ICBT compared to TAU is 0.8 (Cohen's d) and with 60 participants and some attrition this will result in a statistical power of 80% for this initial, smaller RCT.

Conditions

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Antenatal Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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ICBT

Internet-based CBT for antenatal depression

Group Type EXPERIMENTAL

ICBT for antenatal depression

Intervention Type BEHAVIORAL

Participants receives active therapist support via the internet to go through a 10-week self-help treatment on a secure web platform

TAU

Treatment as usual provided at antenatal clinics and other health care instances

Group Type ACTIVE_COMPARATOR

TAU

Intervention Type OTHER

Treatment as usual provided at antenatal clinics and other health care instances

Interventions

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ICBT for antenatal depression

Participants receives active therapist support via the internet to go through a 10-week self-help treatment on a secure web platform

Intervention Type BEHAVIORAL

TAU

Treatment as usual provided at antenatal clinics and other health care instances

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* pregnant female \> 18 years old at gestational week 11-28
* verified moderate depression according to SCID-I with or without concomitant anxiety disorder
* able to understand the Swedish language orally and in written
* able to use the internet for the ICBT
* currently in contact with an antenatal clinic to receive regular care

Exclusion Criteria

* known drug or alcohol abuse
* serious somatic disorder or psychiatric disorder such as psychosis, bipolar disorder, severe personality disorder, autism or mental retardation and severe melancholic or psychotic depression,
* having started or changed medication with SSRI, SNRI or mood-stabilizers within 3 weeks,
* according to psychiatric assessment have a high suicide risk will be excluded from the study. These women will be helped to receive necessary psychiatric treatment as usual.
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Viktor Kaldo

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Internetpsykiatrienehten (Internet Psychiatry Unit), Psykiatri Sydväst, SLSO

Stockholm, , Sweden

Site Status

Countries

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Sweden

References

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Forsell E, Bendix M, Hollandare F, Szymanska von Schultz B, Nasiell J, Blomdahl-Wetterholm M, Eriksson C, Kvarned S, Lindau van der Linden J, Soderberg E, Jokinen J, Wide K, Kaldo V. Internet delivered cognitive behavior therapy for antenatal depression: A randomised controlled trial. J Affect Disord. 2017 Oct 15;221:56-64. doi: 10.1016/j.jad.2017.06.013. Epub 2017 Jun 13.

Reference Type DERIVED
PMID: 28628768 (View on PubMed)

Related Links

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Other Identifiers

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20141959311

Identifier Type: -

Identifier Source: org_study_id

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