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RecruitingNCT06046456PACTUpdated Jul 8, 2024

Prenatal Affective Cognitive Training to Reduce the Risk of Postpartum Depression (PACT)

An interventional study of Prenatal Affective CogntiiveTraining in Postpartum Depression, Emotional Regulation and Cognitive Function 1, Social, sponsored by Mental Health Services in the Capital Region, Denmark. Recruiting at 1 site in Denmark. Open to female participants aged 18 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-08.

Sponsored by Mental Health Services in the Capital Region, Denmark · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
146
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
Female
01

Study summary

Many pregnant women face the risk of experiencing depression after giving birth, especially if they've previously dealt with depression.

The goal of this study, is to test if our newly developed Prenatal Affective Cognitive Training (PACT) intervention, can decrease the likelihood of post partum depression. In the study, 226 pregnant women, some of whom are considered high risk due to past mental illness or psycho-social risk factors, will participate. The high-risk women will be divided into two groups. One group will undergo the PACT training, which involves computer and virtual reality exercises spanning five weeks, designed to improve mood and emotional regulation. The other group will receive usual care. The study also involves a low-risk group (n=146), although these individuals are not part of the intervention trial but are merely followed up with the same assessments for background comparisons.The main aim is to observe whether the women who undergo PACT intervention are less prone to depression after childbirth compared to those who do not.

This study has potential to offer a simple, non-invasive method to bolster mental health in expectant mothers, which could also positively impact their infants.

02

Conditions studied

  • Postpartum Depression
  • Emotional Regulation
  • Cognitive Function 1, Social
  • Pregnancy Related
  • Mother-Child Relations
03

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria for General Pregnant Population:

  • Second or third trimester pregnancy.
  • Age ≥ 18 years.
  • Ability to speak and read Danish.

Inclusion Criteria for High-Risk Pregnant Group:

  • Either:
  • Negative cognitive bias in emotional reactivity to infant distress (cut-off > 96 on a scale from 0-100).
  • High-risk status according to the Antenatal Risk Questionnaire (ANRQ) which means:
  • Personal history of severe mental illness.
  • Experienced childhood emotional, physical, or sexual abuse.
  • Total score on psycho-social risk factors is above the cut-off (> 23).

Inclusion Criteria for Low-Risk Pregnant Group:

  • Absence of a personal or family history of mental illness.
  • Absence of negative bias.
  • Three or fewer of the additional risk factors mentioned above.

General Exclusion Criteria:

  • Schizophrenia.
  • Current substance use disorder.
  • Score of 9 or more on the Hamilton Depression Rating Scale-6 items (HDRS-6), indicating moderate depression.
  • Pregnant women diagnosed with a personality disorder (note: they will still be included at baseline and follow-up after birth but will be excluded from randomization).
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
146 participants (estimated)

Study arms

  • Experimental
    PACT

    Receive the intervention

    Other: Prenatal Affective CogntiiveTraining

  • No intervention
    CAU

    Receive care as usual, i.e., the standard care provided to pregnant women without any additional experimental interventions. It typically involves routine prenatal care, which may include regular check-ups, medical assessments, and general support from healthcare professionals

Interventions

  • OtherPrenatal Affective CogntiiveTraining

    A psychological intervention using computer- and virtual reality based exercises to modify negative cognitive bias and improve emotion regulation

05

What researchers measure

Primary outcomes

  1. The incidence of PPD during the first six months after birth, assessed with the Present State Examination (PSE), which is a part of Schedules for Clinical Assessment in Neuropsychiatry (SCAN)

    The primary outcome is the difference between mothers receiving PACT versus CAU in the incidence of PPD during the first six months after birth, assessed by a clinician blind to group status with the Present State Examination (PSE), which is a part of Schedules for Clinical Assessment in Neuropsychiatry (SCAN)

    Time frame: Six months after birth

Secondary outcomes

  1. Change in negative cognitive bias

    Differences between participants receiving PACT and CAU in the change in negatively biased cognitive processing of infant stimuli from baseline to follow-up during pregnancy (T1) as measured with computerized testing

    Time frame: In third trimester of pregnancy

  2. Self-rated depressive symptoms

    Differences between participants receiving PACT and CAU in severity of depressive symptoms during the first six weeks after birth measured with the Edinburgh Postpartum Depression Scale

    Time frame: Within six weeks after birth

  3. Self-rated parental stress

    Self-rated parental stress with the Parental Stress Scale at six months after birth.

    Time frame: Six months after birth

Other outcomes

  1. Infant development

    Tertiary outcome involve assessing differences in infant development as measured with the Bayley Scales version 4 between the PACT and CAU groups

    Time frame: Eight - eighteen months after birth

  2. Mother-child interaction

    Tertiary outcome involve assessing differences in mother-child interaction measures (e.g., sensitivity, intrusiveness, dyadic reciprocity and neural synchrony) between the PACT and CAU groups as measured with behavioural coding (Coding Interactive Behaviour) and fNIRS brain scan.

    Time frame: Eight - eighteen months after birth

  3. Change in affective cognition

    Tertiary outcome involve assessing differences in the changes in facial expressions and visual attention towards infant stimuli (from T0 to T1 during pregnancy) between the PACT and CAU groups, as measured with computerized testing

    Time frame: Third trimester of pregnancy

06

Study locations

1 of 1 sites recruiting
  • Mental Health Services in The Capital Region of Denmark
    Copenhagen, 2000, Denmark
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06046456
Lead sponsor
Mental Health Services in the Capital Region, Denmark
Collaborators
University of Copenhagen
Responsible party
Sponsor
First posted
Sep 21, 2023
Start date
Jan 10, 2023
Primary completion
Feb 2025 (estimated)
Completion
Jul 2025 (estimated)
Last update
Jul 8, 2024

Study contacts

Anne J Bjertrup, PhD
Contact
anne.juul.bjertrup@regionh.dk
27134839
Anne Bjertrup
Contact
anne_bjertrup@hotmail.com
27134839
Kamill W Miskowiak, DMsc
principal investigator · Mental Health Services in the Capital Region of Denmark

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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