Optimising therapy for women with anxiety disorders in pregnancy
What is the study about?
Anxiety disorders (including Post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social anxiety disorder and panic disorder), affect approximately 11% of pregnant women.
Cognitive behaviour therapy (CBT), a well-known talking therapy, is known to be an effective treatment for anxiety disorders and this is routinely offered to pregnant women with anxiety disorders.
Recently, studies have demonstrated that the same CBT treatment delivered in a shorter space of time, over fewer but longer sessions in a few weeks, can be as helpful, meaning people can get better more quickly. However, this format has not been explored for women who are currently pregnant.
This research aims to investigate whether pregnant women with anxiety disorders find the format of time intensive CBT (IN-CBT) helpful and if it is possible to test it against the current standard format, weekly CBT.
Everyone taking part will get treatment as soon as possible after referral. All women taking part will get a course of one-to-one CBT for their anxiety disorder.
The study includes women over 18 who live in Lambeth, Lewisham, Southwark or Croydon. Women who live outside these boroughs may be able to participate - please enquire.
You need to be between 12 and 20 weeks pregnant to enrol in the study.
Find out exactly what is involved by reading the information sheet and/or getting in touch with Dr. Fiona Challacombe
The study is funded by the NIHR
Please get in touch if you have any questions at all.
Which anxiety disorders are
we treating in this study?
Obsessive Compulsive Disorder (OCD)
OCD is a problem characterised by repeated unwanted thoughts of something bad happening (obsessions) and actions aimed at preventing this (compulsions). Examples of obsessions in pregnancy could be that the baby will be harmed by something you came into contact with, thoughts of impulsively harming the baby even though you do not want to, or that the baby may not be your partners even though this is not possible. OCD can be about all sorts of things so this list is not exhaustive. Examples of compulsions would be excessive cleaning, checking or going over things in your mind to make sure you did not harm anyone. Occasional thoughts and behaviours of this nature are normal; OCD is when the problem is excessive and is interfering with your life. CBT can help people understand and tackle their symptoms so that they do not interfere.
Social Anxiety Disorder
Social anxiety disorder, also known as social phobia is the fear of being judged for doing something embarrassing in front of other people. People feel very anxious in and often avoid social situations, or use strategies to manage them such as preparing conversations, or masking the signs of anxiety in some way. It is very common but often people do not come forward for help, not realising it is a very treatable problem. Sometimes people use strategies such as alcohol to manage social anxiety, so becoming pregnant can be a problem if it is no longer possible to use this. It is also a time of meeting lots of new people which can be stressful. CBT can help people understand and test out their fears and develop new strategies to feel more confident in social situations.
Panic attacks are the experience of suddenly becoming very anxious and feeling a number of symptoms very intensely, such as beating heat, sweating, feeling dizzy or unreal, thoughts that you might die, faint, or lose control. Panic disorder is the experience of repeated panic attacks that seem to come out of the blue. As they are very unpleasant experiences, people can often worry between attacks about having another one. They can be difficult experiences, especially in pregnancy. CBT can help people understand their symptoms and develop new strategies to deal with the symptoms of panic.
Post-traumatic Stress Disorder (PTSD)
After a very stressful, frightening event some people will develop PTSD. This is the experience of reliving parts of the event, avoiding thinking or talking about the event or parts of it, feeling emotionally numb, or jumpy and on edge. It can be linked to feeling irritable or cut off from others. Many events can trigger PTSD, such as a traumatic birth experience, serious accidents and physical or sexual assaults. The experience of being pregnant can bring symptoms to the surface for people, particularly if the trauma is a past experience of birth or sexual assault. CBT can help people understand their symptoms and put the memory firmly in the past.
The information sheet can be found here. Please get in touch if you are interested in taking part or have any questions about the study
PO31, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF