Abstract

Background

Postpartum depression (PPD) affects 30–50% of women with a history of previous depression or bipolar disorder and 8% of women with no history of depression. Negative cognitive biases in the perception of infant cues and difficulties with emotion regulation are replicated risk factors. Current interventions focus on detecting and treating rather than preventing PPD. The aim of this randomized controlled intervention trial is therefore to investigate the potential prophylactic effects of prenatal affective cognitive training for pregnant women at heightened risk of PPD.

Methods

The study will enrol a total of 292 pregnant women: 146 at high risk and 146 at low risk of PPD. Participants undergo comprehensive assessments of affective cognitive processing, clinical depressive symptoms, and complete questionnaires at baseline. Based on the responses, pregnant women will be categorized as either at high or low risk of PPD. High-risk participants will be randomized to either prenatal affective cognitive training (PACT) or care as usual (CAU) immediately after the baseline testing. The PACT intervention is based on emerging evidence for efficacy of affective cognitive training approaches in depression, including cognitive bias modification, attention bias modification, mindfulness-inspired emotion regulation exercises, and working memory training. Participants randomised to PACT will complete five individual computerised and virtual reality-based training sessions over 5 weeks. The primary outcome is the difference between intervention arms in the incidence of PPD, assessed with an interview 6 months after birth. We will also assess the severity of depressive symptoms, rated weekly online during the first 6 weeks postpartum.

Discussion

The results will have implications for future early prophylactic interventions for pregnant women at heightened risk of PPD. If the PACT intervention reduces the incidence of PPD, it can become a feasible, non-invasive prophylactic strategy during pregnancy, with positive mental health implications for these women and their children.

Trial registration

ClinicalTrials.gov NCT06046456 registered 21-09-2023, updated 08-07-2024.

Details

Title
Prenatal affective cognitive training to reduce the risk of postpartum depression (PACT): study protocol for a randomized controlled trial
Author
Bjertrup, Anne J. 1   VIAFID ORCID Logo  ; Kofoed, Jeanne 1 ; Egmose, Ida 2 ; Wendelboe, Katrine 2 ; Southgate, Victoria 2 ; Væver, Mette S. 2 ; Miskowiak, Kamilla W. 3 

1  Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, The Neurocognition and Emotion in Affective Disorders Centre (NEAD), Frederiksberg, Denmark (GRID:grid.466916.a) (ISNI:0000 0004 0631 4836) 
2  University of Copenhagen, Department of Psychology, Faculty of Social Sciences, Copenhagen, Denmark (GRID:grid.5254.6) (ISNI:0000 0001 0674 042X) 
3  Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, The Neurocognition and Emotion in Affective Disorders Centre (NEAD), Frederiksberg, Denmark (GRID:grid.466916.a) (ISNI:0000 0004 0631 4836); University of Copenhagen, Department of Psychology, Faculty of Social Sciences, Copenhagen, Denmark (GRID:grid.5254.6) (ISNI:0000 0001 0674 042X) 
Pages
478
Publication year
2024
Publication date
Dec 2024
Publisher
Springer Nature B.V.
e-ISSN
17456215
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13063-024-08316-1
ProQuest document ID
3080896142
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.