title: Preliminary open trial of interpersonal counseling for subsyndromal depression following miscarriage.
abstract: Miscarriage occurs in 10-20% of clinically recognized pregnancies and is associated with two- to fourfold increases in depressive symptoms. No counseling programs for depressed miscarrying women have been manualized or evaluated for safety and efficacy. We investigated whether depressive symptoms decline substantially among miscarrying women receiving one to six weekly sessions of manualized, telephone-administered interpersonal counseling (IPC), a variant of interpersonal psychotherapy (IPT) in an open trial. Depressive symptom levels were measured with the Center for Epidemiologic Studies-Depression (CES-D) scale. Of 65 women evaluated, 24 were study eligible; 17 consented to participate. Change in symptom levels was evaluated by comparing baseline to postintervention CES-D scores in an intention to treat (ITT) sample (n=17) and a completer subsample (n=9). The latter sample comprised women reevaluated postintervention. In the ITT sample, the CES-D mean score declined from 25.4 to 18.8 [mean within-subject change=6.6, 95% confidence interval (CI)=1.4-11.6]; in the completer subsample, it declined from 23.6 to 11.2 (mean within-subject change=12.3, 95% CI=4.0-20.7). Findings from this small open trial suggest that IPC decreases depressive symptoms after miscarriage. A randomized, controlled trial of IPC's safety and efficacy with depressed miscarrying women is warranted.
authors.affiliation: Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, New York, New York 10032, USA. rn3@columbia.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Neugebauer
authors.forename: Jennie
authors.initials: J
authors.lastname: Kline
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bleiberg
authors.forename: Laxmi
authors.initials: L
authors.lastname: Baxi
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
authors.forename: Mark
authors.initials: M
authors.lastname: Rosing
authors.forename: Bruce
authors.initials: B
authors.lastname: Levin
authors.forename: Jessica
authors.initials: J
authors.lastname: Keith
mesh_terms: D000022:Abortion, Spontaneous / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D003376:Counseling; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D011247:Pregnancy; D011256:Pregnancy Outcome; D011613:Psychotherapy; D012720:Severity of Illness Index