Different psychological interventions for perinatal depression: a systematic review and meta-analysis of randomized controlled trials

TL;DR

This study reviews and compares the effectiveness of various psychological treatments for depression during pregnancy and the postpartum period.

Contribution

The study provides a comprehensive meta-analysis of psychological interventions for perinatal depression, highlighting the effectiveness of individualized and non-clinical setting approaches.

Findings

Psychological interventions showed a moderate pooled effect in reducing perinatal depression.

Interpersonal therapy (IPT) appeared more effective than cognitive behavioral therapy (CBT) and other approaches.

Non-specialist therapists with training achieved outcomes similar to specialist therapists.

Abstract

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.

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.

We systematically searched the Ovid platform, covering the MEDLINE, EMBASE, PsycINFO, and Web of Science databases from their inception to March 11, 2024.

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.

This study has high heterogeneity; the limited number of studies on MBI, BA, and PST may affect the accuracy of the meta-analysis results.

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.

The online version contains supplementary material available at 10.1186/s12888-025-07462-3.

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