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What is peripartum depression?

Peripartum depression is more than just “baby blues:” this condition is clinical depression experienced by a person during pregnancy or after giving birth that can continue for months, with symptoms that can be quite severe. About 10 percent of women who give birth will experience peripartum depression – and even more women in different demographic groups will, including up to 33 percent of Latina or Hispanic women. 

There is a large base of evidence that various forms of talk therapy can be effective in addressing peripartum depression. However, this care is not always easy to access for every peripartum patient who could benefit from it. With this in mind, the PCORI-funded Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) trial is comparing different delivery options of talk therapy to treat peripartum depression. 

How can research address peripartum depression?

Peripartum depression will be experienced differently for different patients, and it is essential to have various treatment options available and to understand what works best and for whom. That’s where patient-centered comparative clinical effectiveness research (CER) like SUMMIT comes in.

The SUMMIT trial is comparing four different groups. All participants are receiving behavioral activation therapy – a form of talk therapy which focuses on increasing activities that are enjoyable or fulfilling to a patient, and that align with their values. However, half are working with a mental health professional, while the other half are working with a non-specialist nurse or a midwife. Of each of those two groups, half of the patients receive their care in person while the other half participate via telemedicine appointments. 

Participants have up to eight talk therapy sessions and receive support in focusing on their values and what they find enjoyable and fulfilling. Their levels of anxiety and depression symptoms were measured at baseline as a comparison to check-ins three, six and 12 months later.

Peripartum depression will be experienced differently for different patients, and it is essential to have various treatment options available and to understand what works best and for whom.

What are the implications of this patient-centered research?

Advisory participants such as mothers, patient advocates, those who have experienced anxiety and depression, mental health professionals and other healthcare industry members are helping to plan and execute the SUMMIT trial, in keeping with its patient-centered CER foundations. This ensures that the study’s questions, conduct and findings are as relevant to patients and their support networks as possible.

The study is still in progress, yet already generating important new knowledge. The research team has published findings related to the importance of culturally sensitive treatment, the role of teletherapy in the wake of the COVID-19 pandemic and in light of racial injustices, and more. While the final research findings have not yet been reported, the scope of  the trial presents the possibility of greatly increasing understanding of how to ensure access to treatment for perinatal depression and anxiety.

Once completed, the trial could support a sweeping increase in access to peripartum depression treatment. This patient-centered CER is offering support to the field of peripartum depression treatment, and in turn behavioral activation support can be provided to more and more mothers to treat their peripartum depression in the future.

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