Internet CBT for Antenatal Depression

NCT ID: NCT05533138

Last Updated: 2024-06-25

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

RECRUITING

Clinical Phase

NA

Total Enrollment

415 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-25

Study Completion Date

2027-12-31

Brief Summary

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Pregnant women in pregnancy week 8-29 screening positive for antenatal depression will be randomized to either choose or to be allotted by chance to different forms of diagnostic assessment; i.e. telephone, video or face-to-face assessment.

Those diagnosed with mild to moderate major depression will then be randomized to treatment with therapist-guided Internet-delivered Cognitive Behavioral Therapy (ICBT) adapted for women suffering from antenatal depression or to the same treatment with addition of up to three contacts with extra support by a midwife or experienced perinatal mental health nurse.

The primary aim is to assess whether extrasupport in addition to internet-guided pregnancy adapted ICBT decreases depressive symptoms more than internet-guided pregnancy adapted ICBT only. Secondary aims include effects of extrasupport and assessment mode on treatment satisfaction, fidelity and credibility.

Detailed Description

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Conditions

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Antenatal Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Multiple Assignment Randomized Trial
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Participants are blinded for allocation to perinatal extra support in addition to therapist-guided internet CBT treatment.

Outcome is assessed by an independent assessor who is blind for whether patient chose or was allocated to assessment modality and whether patient received extra-support or not.

Study Groups

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Assessment form allocated by chance & guided ICBT for antenatal depression

Patients are randomized to assessment modality (telephone, video or face-to-face visit) of a perinatal psychiatric semi-structured assessment \& and are randomised to treatment with internet-CBT for antenatal depression without extra-support (10 weeks)

Group Type ACTIVE_COMPARATOR

Therapist Guided Internet-CBT for antenatal depression

Intervention Type BEHAVIORAL

A 10 week long, structured self-help program with weekly reports to, and feedback from, a CBT therapist over the Internet. Includes traditional CBT-methods for depression adapted for antenatal depression.

Diagnostic assessment by telephone, video or face-to face - Allocation by chance

Intervention Type BEHAVIORAL

Structured diagnostic perinatal psychiatric assessment of women screening positive for antenatal depression (pregnancy week 8-29) by telephone, video or in a face-to-face meeting. Assessment form allocation by chance.

Assessment form allocated by choice & guided ICBT for antenatal depression

Patients choose assessment modality (telephone, video or face-to-face visit) of a perinatal psychiatric semi-structured assessment \& are randomised to treatment with internet-CBT for antenatal depression without extra-support (10 weeks)

Group Type ACTIVE_COMPARATOR

Therapist Guided Internet-CBT for antenatal depression

Intervention Type BEHAVIORAL

A 10 week long, structured self-help program with weekly reports to, and feedback from, a CBT therapist over the Internet. Includes traditional CBT-methods for depression adapted for antenatal depression.

Diagnostic assessment by telephone, video or face-to face - Allocation by choice

Intervention Type BEHAVIORAL

Structured diagnostic perinatal psychiatric assessment of women screening positive for antenatal depression (pregnancy week 8-29) by telephone, video or in a face-to-face meeting. Assessment form allocation based on patient preference.

Assessment form allocated by chance & guided ICBT for antenatal depression with extra support

Patients are randomized to assessment modality (telephone, video or face-to-face visit) of a perinatal psychiatric semi-structured assessment \& and are randomised to treatment with internet-CBT for antenatal depression with extra-support

Group Type EXPERIMENTAL

Therapist Guided Internet-CBT for antenatal depression and perinatal extra support.

Intervention Type BEHAVIORAL

A 10 week long, structured self-help program with weekly reports to, and feedback from, a CBT therapist over the Internet. Includes traditional CBT-methods for depression adapted for antenatal depression. Additionally, up to three supportive contacts with a midwife or perinatal mental health nurse to support ICBT treatment and adress general pregnancy related health problems.

Diagnostic assessment by telephone, video or face-to face - Allocation by chance

Intervention Type BEHAVIORAL

Structured diagnostic perinatal psychiatric assessment of women screening positive for antenatal depression (pregnancy week 8-29) by telephone, video or in a face-to-face meeting. Assessment form allocation by chance.

Assessment form allocated by choice & guided ICBT for antenatal depression with extra support

Patients choose assessment modality (telephone, video or face-to-face visit) of a perinatal psychiatric semi-structured assessment \& are randomised to treatment with internet-CBT for antenatal depression with extra-support (10 weeks)

Group Type EXPERIMENTAL

Therapist Guided Internet-CBT for antenatal depression and perinatal extra support.

Intervention Type BEHAVIORAL

A 10 week long, structured self-help program with weekly reports to, and feedback from, a CBT therapist over the Internet. Includes traditional CBT-methods for depression adapted for antenatal depression. Additionally, up to three supportive contacts with a midwife or perinatal mental health nurse to support ICBT treatment and adress general pregnancy related health problems.

Diagnostic assessment by telephone, video or face-to face - Allocation by choice

Intervention Type BEHAVIORAL

Structured diagnostic perinatal psychiatric assessment of women screening positive for antenatal depression (pregnancy week 8-29) by telephone, video or in a face-to-face meeting. Assessment form allocation based on patient preference.

Interventions

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Therapist Guided Internet-CBT for antenatal depression

A 10 week long, structured self-help program with weekly reports to, and feedback from, a CBT therapist over the Internet. Includes traditional CBT-methods for depression adapted for antenatal depression.

Intervention Type BEHAVIORAL

Therapist Guided Internet-CBT for antenatal depression and perinatal extra support.

A 10 week long, structured self-help program with weekly reports to, and feedback from, a CBT therapist over the Internet. Includes traditional CBT-methods for depression adapted for antenatal depression. Additionally, up to three supportive contacts with a midwife or perinatal mental health nurse to support ICBT treatment and adress general pregnancy related health problems.

Intervention Type BEHAVIORAL

Diagnostic assessment by telephone, video or face-to face - Allocation by chance

Structured diagnostic perinatal psychiatric assessment of women screening positive for antenatal depression (pregnancy week 8-29) by telephone, video or in a face-to-face meeting. Assessment form allocation by chance.

Intervention Type BEHAVIORAL

Diagnostic assessment by telephone, video or face-to face - Allocation by choice

Structured diagnostic perinatal psychiatric assessment of women screening positive for antenatal depression (pregnancy week 8-29) by telephone, video or in a face-to-face meeting. Assessment form allocation based on patient preference.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Mild to moderate major depression
* Pregnant at treatment start
* Regular contact with maternity mental health clinic
* \> 18 years old
* Being able to start the treatment earliest in gestational week 8 and latest in gestational week 30
* Stable medication for depression and/or other psychiatric conditions for at least 3 weeks.
* Being able to participate in the treatment during the treatment time and having access to and being able to use the internet and mobile phone during the treatment time
* Being able to understand the Swedish language orally and in writing

Exclusion Criteria

* Montgomery-Åsberg Depression Rating Scale-Self report version (MADRS-S) score below 15 (symptoms of depression to low) or above 35 (severe depression)
* High risk of self harm or suicide (based on semi-structured clinical suicide risk assessment)
* Psychiatric comorbidity, disability, somatic disorder, or pregnancy complications that prevent treatment participation or that can be negatively affected or compose a risk for the fetus by treatment participation
* Ongoing psychological treatment with similar content
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Region Stockholm

OTHER_GOV

Sponsor Role collaborator

Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Marie Bendix

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marie Bendix, PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

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Psychiatry Southwest, Department of CL Psychiatry & Internetpsychiatry

Stockholm, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Marie Bendix, PhD

Role: CONTACT

+46 73 6370 864

Facility Contacts

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Marie Bendix, PhD

Role: primary

+46 73 637 0864

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 BACKGROUND
PMID: 28628768 (View on PubMed)

Related Links

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https://dana.ki.se

The homepage for the study where patients can register

Other Identifiers

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2020-06049

Identifier Type: -

Identifier Source: org_study_id

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