Different psychological interventions for perinatal depression: a systematic review and meta-analysis of randomized controlled trials
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Background
Psychological interventions are the preferred treatment for women with perinatal depression, but there is a lack of comprehensive meta-analyses evaluating their effectiveness and the impact of related variables.
Objective
We performed a systematic review and meta-analysis to assess the efficacy of psychological interventions for perinatal depression and to examine the influence of associated variables.
Methods
We systematically searched the Ovid platform, covering the MEDLINE, EMBASE, PsycINFO, and Web of Science databases from their inception to March 11, 2024.
Results
We screened 5,827 articles, and 33 were included in a random-effects meta-analysis. Compared to the control groups, psychological interventions showed a moderate pooled effect size (SMD: -0.65; 95% CI: -0.87 to -0.43, moderate certainty of evidence). Subgroup analyses suggested that individualized interventions tended to be more effective than group‑based approaches, although this difference may be influenced by other factors such as intervention duration or setting. Additionally, interventions delivered in non‑clinical settings (e.g., participants’ homes or community centers) maybe been more effective than those delivered in clinical settings. In the included studies, non-specialist therapists who received professional training appeared to achieve treatment outcomes for perinatal depression that were broadly similar to those reported for specialist therapists. Variability in the effectiveness of different psychological interventions was observed, with IPT showing a tendency toward a larger effect size compared to CBT.
Limitations
This study has high heterogeneity; the limited number of studies on MBI, BA, and PST may affect the accuracy of the meta-analysis results.
Conclusions
IPT, CBT, MBI, and BA have been shown to effectively alleviate perinatal depression, while PST did not demonstrate significant efficacy. IPT appeared to be more effective than the other interventions, although direct head-to-head comparisons were not conducted. Additionally, personalized interventions in non-clinical settings may be more beneficial. Furthermore, a trained non-mental health therapist may also achieve positive outcomes when delivering psychological interventions.
