Depression: a trial of antenatal guided self help for women (DAWN)
Research type
Research Study
Full title
Depression: an exploratory parallel-group randomised controlled trial of antenatal guided self help for women (DAWN)
IRAS ID
152300
Contact name
Louise M. Howard
Contact email
Sponsor organisation
King’s College London
Research summary
Pregnancy does not appear to be protective against the persistence or development of psychiatric disorders. Depression is the most common antenatal disorder, with rates among pregnant women comparable to rates among non-pregnant women of childbearing age. Antenatal depression can have a considerable impact upon the woman and her family, and is associated with: a) adverse effects on the foetus, including low birth weight and preterm delivery; b) infant deaths; c) postnatal psychopathology; d) subsequent behavioural/emotional problems in the child and adolescent; e) negative impacts for other family members. Early effective interventions are therefore needed. Since mental disorders in pregnancy are also associated with other risk factors that may lead to adverse outcomes, particularly smoking, socio-economic deprivation, obesity and domestic violence, consideration of associated risk factors should also be included in the development of interventions.
The National Institute for Health and Care Excellence (NICE) recommends a stepped care approach for depression, starting with Guided Self Help - a low cost psychological intervention for mild and moderate depression - delivered by NHS Psychological Wellbeing Practitioners. A recent systematic review and meta-analysis of Guided Self Help found evidence of effectiveness post-treatment but limited effectiveness at long term follow-up; no trials in perinatal settings were included. A recent Australian study of an antenatal supported Self Help intervention for the prevention of perinatal common mental symptoms reported reduced depressive symptoms at 12 weeks post-delivery.
To our knowledge there has been no evaluation of less intensive psychological interventions in the antenatal setting, which may be more cost-effective for mild and moderate antenatal depression. We will, therefore, conduct an exploratory randomised controlled trial to evaluate Guided Self Help materials, modified for antenatal depression, in women using NHS maternity services.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
14/LO/0597
Date of REC Opinion
11 Jun 2014
REC opinion
Further Information Favourable Opinion