1
|
Soukup T, Davis RE, Baldellou Lopez M, Healey A, Estevao C, Fancourt D, Dazzan P, Pariante C, Dye H, Osborn T, Bind R, Sawyer K, Rebecchini L, Hazelgrove K, Burton A, Manoharan M, Perkins R, Podlewska A, Chaudhuri R, Derbyshire-Fox F, Hartley A, Woods A, Crane N, Bakolis I, Sevdalis N. Study protocol: randomised controlled hybrid type 2 trial evaluating the scale-up of two arts interventions for postnatal depression and Parkinson's disease. BMJ Open 2022; 12:e055691. [PMID: 35105591 PMCID: PMC8808453 DOI: 10.1136/bmjopen-2021-055691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/21/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Research on the benefits of 'arts' interventions to improve individuals' physical, social and psychological well-being is growing, but evidence on implementation and scale-up into health and social care systems is lacking. This protocol reports the SHAPER-Implement programme (Scale-up of Health-Arts Programmes Effectiveness-Implementation Research), aimed at studying the impact, implementation and scale-up of: Melodies for Mums (M4M), a singing intervention for postnatal depression; and Dance for Parkinson's (PD-Ballet) a dance intervention for Parkinson's disease. We examine how they could be embedded in clinical pathways to ensure their longer-term sustainability. METHODS AND ANALYSIS A randomised two-arm effectiveness-implementation hybrid type 2 trial design will be used across M4M/PD-Ballet. We will assess the implementation in both study arms (intervention vs control), and the cost-effectiveness of implementation. The design and measures, informed by literature and previous research by the study team, were refined through stakeholder engagement. Participants (400 in M4M; 160 in PD-Ballet) will be recruited to the intervention or control group (2:1 ratio). Further implementation data will be collected from stakeholders involved in referring to, delivering or supporting M4M/PD-Ballet (N=25-30 for each intervention).A mixed-methods approach (surveys and semi-structured interviews) will be employed. 'Acceptability' (measured by the 'Acceptability Intervention Measure') is the primary implementation endpoint for M4M/PD-Ballet. Relationships between clinical and implementation outcomes, implementation strategies (eg, training) and outcomes will be explored using generalised linear mixed models. Qualitative data will assess factors affecting the acceptability, feasibility and appropriateness of M4M/PD-Ballet, implementation strategies and longer-term sustainability. Costs associated with implementation and future scale-up will be estimated. ETHICS AND DISSEMINATION SHAPER-PND (the M4M trial) and SHAPER-PD (the PD trial) are approved by the West London and GTAC (20/PR/0813) and the HRA and Health and Care Research Wales (REC Reference: 20/WA/0261) Research Ethics Committees. Study findings will be disseminated through scientific peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBERS Both trials are registered with NIH US National Library of Medicine, ClinicalTrials.gov. The trial registration numbers, URLs of registry records, and dates of registration are: (1) PD-Ballet: URL: NCT04719468 (https://eur03.safelinks.protection. OUTLOOK com/?url=https%3A%2F%2Fwww.clinicaltrials.gov%2Fct2%2Fshow%2FNCT04719468%3Fterm%3DNCT04719468%26draw%3D2%26rank%3D1&data=04%7C01%7Crachel.davis%40kcl.ac.uk%7C11a7c5142782437919f808d903111449%7C8370cf1416f34c16b83c724071654356%7C0%7C0%7C6375441942616) (date of registration: 22 Jan 2021). (2) Melodies for Mums: NCT04834622 (https://clinicaltrials.gov/ct2/show/NCT04834622?term=shaper-pnd&draw=2&rank=1) (date of registration: 8 Apr 2021).
Collapse
Affiliation(s)
- Tayana Soukup
- Centre Implementation Science, King's College London, London, UK
| | - Rachel E Davis
- Centre Implementation Science, King's College London, London, UK
| | | | - Andy Healey
- Centre Implementation Science, King's College London, London, UK
| | - Carolina Estevao
- Department of Psychological Medicine, King's College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, King's College London, London, UK
| | - Carmine Pariante
- Department of Psychological Medicine, King's College London, London, UK
| | - Hannah Dye
- Breathe Arts Health Research, London, UK
| | - Tim Osborn
- Breathe Arts Health Research, London, UK
| | - Rebecca Bind
- Department of Psychological Medicine, King's College London, London, UK
| | - Kristi Sawyer
- Department of Psychological Medicine, King's College London, London, UK
| | | | - Katie Hazelgrove
- Department of Psychological Medicine, King's College London, London, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, London, UK
| | | | - Rosie Perkins
- Faculty of Medicine, Imperial College London, London, UK
- Centre for Performance Science, Royal College of Music, London, UK
| | - Aleksandra Podlewska
- Department of Basic and Clinical Neuroscience, King's College London, London, UK
| | - Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, King's College London, London, UK
| | | | | | - Anthony Woods
- Department of Psychological Medicine, King's College London, London, UK
| | - Nikki Crane
- Department of Psychological Medicine, King's College London, London, UK
| | - Ioannis Bakolis
- Centre Implementation Science, King's College London, London, UK
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Nick Sevdalis
- Centre Implementation Science, King's College London, London, UK
| |
Collapse
|
2
|
Cuomo A, Maina G, Neal SM, De Montis G, Rosso G, Scheggi S, Beccarini Crescenzi B, Bolognesi S, Goracci A, Coluccia A, Ferretti F, Fagiolini A. Using sertraline in postpartum and breastfeeding: balancing risks and benefits. Expert Opin Drug Saf 2018; 17:719-725. [PMID: 29927667 DOI: 10.1080/14740338.2018.1491546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The World Health Organization recommends newborns to be breastfed but this may be challenging if the mother needs to be treated for depression, since strong evidence to inform treatment choice is missing. AREAS COVERED We provide a critical review of the literature to guide clinicians who are considering sertraline for the management of depression during postpartum. EXPERT OPINION Sertraline is one of the safest antidepressants during breastfeeding. In most cases, women already taking sertraline should be advised to breastfeed and continue the medication. We recommend to begin with low doses and to slowly increase the dose up, with careful monitoring of the newborn for adverse effects (irritability, poor feeding, or uneasy sleep, especially if the child was born premature or had low weight at birth). The target dose should be the lowest effective. When feasible, child exposure to the medication may be reduced by avoiding breastfeeding at the time when the antidepressant milk concentration is at its peak. A decision to switch to sertraline from ongoing and effective treatment should be taken only after a scrupulous evaluation of the potential risks and benefits of switching versus continuing the ongoing medication while monitoring the infant carefully.
Collapse
Affiliation(s)
- Alessandro Cuomo
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| | - Giuseppe Maina
- b University of Torino , Department of Neuroscience (GM , GR )
| | - Stephen M Neal
- c The Department of Psychiatry , West Virginia School of Osteopathic Medicine (SMN)
| | - Graziella De Montis
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| | - Gianluca Rosso
- b University of Torino , Department of Neuroscience (GM , GR )
| | - Simona Scheggi
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| | - Bruno Beccarini Crescenzi
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| | - Simone Bolognesi
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| | - Arianna Goracci
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| | - Anna Coluccia
- d University of Siena Department of Medical , Sugical and Neurological Sciences (AC2, FF)
| | - Fabio Ferretti
- d University of Siena Department of Medical , Sugical and Neurological Sciences (AC2, FF)
| | - Andrea Fagiolini
- a University of Siena , Department of Molecular and Developmental Medicine (AC, GDM, SS, BBC, SB, AG, AF)
| |
Collapse
|
3
|
Interpersonal psychotherapy for postpartum depression: a systematic review. Arch Womens Ment Health 2014; 17:257-68. [PMID: 24957781 DOI: 10.1007/s00737-014-0442-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/11/2014] [Indexed: 10/25/2022]
Abstract
Interpersonal psychotherapy (IPT) is a dynamically informed and present-focused psychotherapy originally conceived for patients with unipolar depression and subsequently modified for other disorders, including postpartum depression (PPD). The aim of this paper is to review the evidence on the efficacy of IPT for PPD. We conducted a systematic review of studies published between 1995 and April 2013 assessing the efficacy of IPT for PPD using PubMed and PsycINFO. We included the following: (i) articles that presented a combination of at least two of the established terms in the abstract, namely, interpersonal [all fields] and ("psychotherapy" [MeSH terms] or psychotherapy [all fields]) and (perinatal [all fields] or postpartum [all fields]) and ("depressive disorder" [MeSH terms] or ("depressive" [all fields] and "disorder" [all fields]) or depressive disorder [all fields] or "depression" [all fields] or depression [MeSH terms]); (ii) manuscripts in English; (iii) original articles; and (iv) prospective or retrospective observational studies (analytical or descriptive), experimental, or quasi-experimental. Exclusion criteria were as follows: (i) other study designs, such as case reports, case series, and reviews; (ii) non-original studies including editorials, book reviews, and letters to the editor; and (iii) studies not specifically designed and focused on IPT. We identified 11 clinical primary trials assessing the efficacy of IPT for PPD, including 3 trials with group interventions (G-IPT) and one that required the presence of the partner (PA-IPT). We also identified six studies interpersonal-psychotherapy-oriented preventive interventions for use in pregnancy. IPT studies showed overall clinical improvement in the most commonly used depression measures in postpartum depressed women (EPDS, HDRS, BDI) and often-full recovery in several cases of treated patients. Evidence from clinical trials indicates that, when administered in monotherapy (or in combination with antidepressants), IPT may shorten the time to recovery from PPD and prolong the time spent in clinical remission.
Collapse
|
4
|
Abstract
Perinatal depression is prevalent and has a great impact on both mother and infant. There are empirically validated treatments for both postpartum depression and depression during pregnancy. Primary among these is Interpersonal Psychotherapy, which has been shown to be effective for postpartum women across the spectrum from mild to severe depression. At present, Interpersonal Psychotherapy is the best validated treatment for postpartum depression and should be considered first-line treatment, especially for depressed breastfeeding women.
Collapse
Affiliation(s)
- Scott Stuart
- University of Iowa, Department of Psychiatry, Psychology, Iowa City, Iowa 52242, USA.
| |
Collapse
|
5
|
Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression. Am J Obstet Gynecol 2009; 200:357-64. [PMID: 19318144 DOI: 10.1016/j.ajog.2008.11.033] [Citation(s) in RCA: 247] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 10/30/2008] [Accepted: 11/17/2008] [Indexed: 12/12/2022]
Abstract
Postpartum depression (PPD) affects up to 15% of mothers. Recent research has identified several psychosocial and biologic risk factors for PPD. The negative short-term and long-term effects on child development are well-established. PPD is under recognized and under treated. The obstetrician and pediatrician can serve important roles in screening for and treating PPD. Treatment options include psychotherapy and antidepressant medication. Obstacles to compliance with treatment recommendations include access to psychotherapists and concerns of breastfeeding mothers about exposure of the infant to antidepressant medication. Further research is needed to examine systematically the short-term and long-term effect of medication exposure through breastmilk on infant and child development.
Collapse
|
6
|
Abstract
This article presents a case study of a new mother experiencing postpartum depression and altered attachment with her newborn. Theories related to postpartum depression and maternal-newborn attachment are reviewed, and evidenced-based strategies for care are discussed in the context of the case.
Collapse
|
7
|
Clark R, Tluczek A, Brown R. A mother-infant therapy group model for postpartum depression. Infant Ment Health J 2008. [DOI: 10.1002/imhj.20189] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
8
|
Abstract
AIM To watch videos on postnatal depression which are used by professionals, mothers and voluntary agencies and to review their quality, content, and themes. BACKGROUND To our knowledge there have been no previous studies of video tapes on postnatal depression for use by mothers and health care professionals during the antenatal and postnatal periods. A core group, consisting of a psychiatrist, health visitor and a mother, watched videos produced in the English language from Australia, South Africa, United States of America (USA) and the United Kingdom (UK). We found a similarity in all video tapes reviewed with regard to the feelings expressed by mothers and fathers. However, some of the context and culture differed in several countries where, during the management and treatment of postnatal depression, a medical rather than social model was preferred.
Collapse
Affiliation(s)
- Jane Hanley
- School of Health Science, University of Wales - Swansea campus, St David's Park, Carmarthen, Wales
| | | | | |
Collapse
|
9
|
Pearlstein TB, Zlotnick C, Battle CL, Stuart S, O'Hara MW, Price AB, Grause MA, Howard M. Patient choice of treatment for postpartum depression: a pilot study. Arch Womens Ment Health 2006; 9:303-8. [PMID: 16932988 DOI: 10.1007/s00737-006-0145-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2006] [Accepted: 07/19/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The lack of systematic efficacy research makes the selection of optimal treatment for postpartum depression (PPD) difficult. Moreover, the treatment decisions for women with PPD who are breastfeeding are heavily influenced by their concerns about infant exposure to antidepressant medication. The objective of this pilot trial was to examine the clinical characteristics of women with PPD associated with treatment selection. METHOD This open pilot trial offered 23 women with PPD one of 3 treatment options: sertraline, interpersonal psychotherapy (IPT), or their combination administered in an outpatient mental health setting over 12 weeks. Baseline and treatment outcome measures included the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory (BDI) and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS Completers across all 3 treatment groups (n = 18) experienced significant clinical improvement with each of the 3 treatment modalities on the HRSD (p < 0.001), BDI (p < 0.001) and EPDS (p < 0.001). There were trends for women with a prior depression to more frequently choose sertraline as a treatment (alone or with IPT, p = 0.07), and for women who were breastfeeding to choose sertraline (alone or with IPT, p = 0.10) less frequently. CONCLUSION In this small sample of women with PPD, most women chose IPT with or without sertraline. A larger randomized study could further confirm the suggested predictors of treatment selection identified in this study: previous depression and breastfeeding status.
Collapse
Affiliation(s)
- T B Pearlstein
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI 02905, USA.
| | | | | | | | | | | | | | | |
Collapse
|