NIH Clinical Research Studies

Protocol Number: 03-M-0138

Active Accrual, Protocols Recruiting New Patients

Title:
A Screening Protocol to Evaluate Women with Postpartum-Related Mood and Behavioral Disorders
Number:
03-M-0138
Summary:
This study evaluates the relationship between mood changes and hormones in women with postpartum depression (PPD).

This is an observational study; volunteers who participate will not receive any new or experimental therapies.

PPD is similar to major depression, but develops around the time a woman gives birth. Women with PPD often suffer serious physical and emotional impairments. Controversy exists regarding the role of hormone changes in postpartum depression. This study will examine the role of hormone changes in three groups of women: those who recently gave birth and have mild to moderately severe PDD (Group 1), women who recently gave birth and do not have PDD (Group 2), and those who are currently pregnant and experienced an episode of PDD with a previous birth (Group 3).

Participants will be screened with a medical history, physical examination, and blood and urine tests. Upon study entry, they will be interviewed about their moods, behaviors, and medical status during and immediately following their last pregnancy. Some women will be asked to participate in interviews, psychological tests, and blood tests. They will also complete self-rating scales and may be asked to collect samples of their urine. Women in Group 3 will complete self-rating scales for 6 months postpartum. Participants will participate in genetic studies that involve completing a questionnaire and providing a blood sample. If the participant allows, sisters and parents may be asked to provide a blood sample and undergo a psychiatric interview.

Participants who meet the criteria for minor depression or major depression that is no greater than moderate severity will be asked to participate in a companion study that will evaluate the effectiveness of estradiol in reducing depression symptoms.

Sponsoring Institute:
National Institute of Mental Health (NIMH)
Recruitment Detail
Type: Participants currently recruited/enrolled
Gender: Female
Referral Letter Required: No
Population Exclusion(s): Male

Children

Eligibility Criteria:
INCLUSION CRITERIA:

A/Cross-sectional Screening: The postpartum subjects of this protocol will be women who meet the following inclusion criteria:

-History of at least two weeks with postpartum-related mood or behavioral disturbances of at least moderate severity - that is, disturbances that are distinct in appearance and associated with a mild to moderate degree of functional impairment;

-The onset of mood symptoms occurred within three months of delivery;

-Age 20-45;

-History of normal delivery (vaginal or caesarean) within last six months;

-No prior estrogen replacement therapy for treatment of postpartum physical or emotional symptoms within the last six months;

-In good medical health.

-Subjects must be competent to comprehend the purpose of the screening process and to provide written informed consent and be willing to participate in NIMH IRB approved research protocols.

-A control group of age-matched postpartum women who meet patient selection criteria with the exception of the presence of mood or behavioral disorders will also be sought.

EXCLUSION CRITERIA:

-Subjects should have no general medical illness that is primary (i.e., appears to be causing the mood disorder);

-Current alcohol or substance use or dependence (excluding nicotine) of sufficient magnitude to require independent, concurrent treatment intervention (e.g., antabuse or opiate treatment, but not including self-help groups).

-There are few exclusion criteria for the evaluation component of this protocol; however, all women will undergo a structured diagnostic interview (see Clinical Assessment section below). Those women who will be asked to participate in the companion protocol evaluating the efficacy of estradiol administration in PPD will meet either research diagnostic criteria for minor depression with at least three core symptoms (SADS-L (79) or major depression (SCID-IV) (80) of not greater than moderate severity on the Global Assessment of Functioning Scale (GAF) (80)) and will not meet DSM-IV criteria # 9 (suicide) or require immediate treatment. Subjects meeting major depression with greater than moderate severity may participate in the evaluation phase of this study but will be offered a referral to an outside facility for standard antidepressant treatment (i.e., they are not candidates for participation in the IRB approved treatment protocol).

B/Longitudinal Screening:

INCLUSION CRITERIA FOR THE AT RISK PREGNANT WOMEN:

-Pregnant;

-Absence of current mood or behavioral disturbance as determined by a structured diagnostic interview;

-Past history of postpartum depression;

-In good medical health,

-Medication free.

C/Genetic Studies:

INCLUSION CRITERIA:

Unaffected family members of women with PPD will be admitted for genetic studies only.

First degree relatives of women with confirmed PPD, who do not have PPD as defined in this protocol.

Special Instructions:
Currently Not Provided
Keywords:
Puerperium
Pregnancy
Mood Disorders
Estradiol
Progesterone
Mood
Behavior
Cognition
Perimenopause
Menopause
Recruitment Keyword(s):
Post Partum Depression
PPD
Healthy Volunteer
HV
Condition(s):
Postpartum Depression
Depression
Investigational Drug(s):
None
Investigational Device(s):
None
Intervention(s):
None
Supporting Site:
National Institute of Mental Health

Contact(s):
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):
Kumar R, Robson KM. A prospective study of emotional disorders in childbearing women. Br J Psychiatry. 1984 Jan;144:35-47.

Cox JL, Murray D, Chapman G. A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry. 1993 Jul;163:27-31.

O'Hara MW, Schlechte JA, Lewis DA, Varner MW. Controlled prospective study of postpartum mood disorders: psychological, environmental, and hormonal variables. J Abnorm Psychol. 1991 Feb;100(1):63-73.

Active Accrual, Protocols Recruiting New Patients

If you have:


Command Menu Bar

Search The Studies | Help | Questions |
Clinical Center Home | NIH Home


Clinical Center LogoNational Institutes of Health Clinical Center Bethesda, Maryland 20892. Last update: 09/16/2008
Search The Studies Help Questions