Antenatal depression is a significant risk factor for postpartum depression with a 10% prevalence in all pregnancies. Despite the prevalence and associated family morbidity, there have been no clinical treatment trials. Pharmacotherapy of pregnant women poses risks of teratogenesis, infant withdrawal at delivery and possible long term infant behavioral effects. Interpersonal Psychotherapy (IPT), a brief psychotherapy shown to be effective in clinical trials, decreases nonpsychotic depressive symptoms. Role transition, a particular area of focus in IPT, makes IPT an appropriate method of psychotherapy during pregnancy. Sleep EEG pattern may be useful in predicting treatment response. Kupfer et al. found that recurrently depressed subjects with a high delta sleep wave ratio on sleep EEGs had a longer time to recurrence after maintenance treatment with IPT compared to those with a lower delta sleep ratio. A 16 week pilot controlled trial comparing IPT for depressed pregnant women (IPT-P) to a parenting education control group is proposed to be conducted on 50 outpatient antepartum women who meet DSMIIIR criteria for depression. Subjects will receive three nights of sleep EEGs. The outcomes of the study will be 1) to determine the relative efficacy of the two treatments and 2) to determine the relationship between sleep EEG and IPT treatment response.
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