Extrait

Background and study aims Maternal postnatal depression (PND) is a major public health issue: it affects around 13% of mothers, and compared to children of non-depressed mothers, the children of mothers with PND are more likely to have learning, behavioural and attachment problems. Treating maternal depression alone does not improve child outcome. An intervention focusing on mother-child interactions is needed to promote these children's development. We aim to examine whether, in the context of PND, a treatment to enhance mother-child interactions leads to improved child outcome. Furthermore, since treatment can be targeted at critical aspects of functioning, a treatment study provides an opportunity to examine potential causal factors in determining child outcome. Thus, we will focus treatment on improving three key parenting capacities that are known to be compromised in PND, and examine whether this improves children's outcomes. Who can participate? Mothers of babies between 5-9 months with PND (a full diagnostic interview will be conducted) who live within a 35 mile radius of Headington, Oxford can enrol into the study. What does the study involve? Mothers with PND will receive home-based treatment from approximately six months postpartum. They will be randomised to one of two treatments: either a treatment using video-feedback (index) to improve mother-child interactions or relaxation training (control). Both groups will also receive cognitive behaviour therapy (CBT) for depression. In total each participant will receive eleven home-based therapy sessions lasting a few months altogether (between baby age 6-12 months), followed by two booster therapy sessions when their baby is around 16 months old. The two groups will be compared post treatment (child age one year) and at follow-up (child age two years) where there will be further assessment visits (at home, and one in our offices in Headington, Oxford). What are the possible benefits and risks of participating? CBT, which all participants will receive, is the treatment recommended by the NHS for people with depression. CBT can help an individual to make changes to the areas of your life that they are not happy with at the moment and may help people to feel better. Relaxation therapy has been shown to be an effective method of helping people to reduce tension, and is a skill that can be used at any time. The support for mother-baby communication using video-feedback treatment has been used in several research studies with mothers and babies, and in general they have enjoyed it and found it to be helpful. Participants need to put aside about an hour and a half for each therapy and assessment session. They may find some of the things we discuss with you upsetting. Where is the study run from? University of Oxford (UK). When is the study starting and how long is it expected to run for? The study started in September 2010. Recruitment is planned to go on until around August 2013, with therapy and follow-up continuing until August 2015. We plan to see around 150 mothers altogether over a total period of five years. Who is funding the study? The Wellcome Trust (UK). Who is the main contact? Mrs Valerie West or Professor Alan Stein [email protected]

Critère d'inclusion

• Postnatal depression

Liens

• ictrp
• isrctn