Effectiveness of Interpersonal Psychotherapy in Treating Pregnant Women With Depression

The prevalence of antepartum depression (APD) increases twofold in women with poor social
supports, low socioeconomic status (SES), and negative life events. APD may cause low birth
weight, premature labor, and eclampsia. APD is also one of the best predictors of postpartum
depression (PPD), which in turn may lead to impaired emotional and cognitive development of
the infant. Therefore, early treatment of APD is important for the well-being of both the
woman and her infant. Forms of psychotherapy have been successful in treating depression in
the general population, but more research is necessary to determine the safest and most
effective means of treating depression in pregnant women. Interpersonal psychotherapy
targets interpersonal events and relationships. Interpersonal psychotherapy adapted for ADP
may be effective in reducing depression, preventing PPD, and improving maternal infant
attachment. This study will compare the effectiveness of interpersonal psychotherapy for
depression in pregnancy (IPT-P) with a parenting education program (PEP) in treating
depressed pregnant women who may be affected by SES and psychosocial factors.

Participation in this single-blind study will last through 6 months postpartum. Potential
participants will first undergo initial screening, which will include a 90-minute interview
with a psychiatrist and a mood assessment with an independent evaluator. Eligible
participants will then be randomly assigned to receive 12 weeks of either IPT-P or PEP.
Participants in both groups will attend 45-minute weekly sessions prior to delivery of their
babies. At each visit, participants will complete questionnaires about mood, anxiety,
mother-infant bonding, and daily function. Participants receiving IPT-P will learn ways to
address emotional stressors associated with childbirth and will be regularly contacted by a
therapist to discuss feelings and emotions. Participants receiving PEP will learn about the
stages of pregnancy, childbirth, and early infant development.

After delivery, participants will receive weekly phone calls from a therapist during the
first 4 weeks. All participants will then return for five evaluation visits, occurring at
Weeks 4, 8, 12, 26, and 24 postpartum. During these visits, a therapist will evaluate
participants' moods and mother-infant attachment and will refer participants to treatment if
needed. The first four visits will be individual evaluations and the last visit will be a
group meeting with other mothers and their infants.