# Which therapy works best for maternal depressive symptoms? A network meta-analysis of psychotherapeutic interventions

## TL;DR

This study finds that cognitive behavioral therapy (CBT) is the most effective psychotherapy for reducing maternal depressive symptoms compared to other interventions.

## Contribution

The study provides the first network meta-analysis comparing psychotherapies for maternal depression, identifying CBT as the most effective.

## Key findings

- CBT showed a statistically significant reduction in depressive symptoms compared to treatment as usual (MD = -3.22).
- Other interventions did not show statistically significant improvements in maternal depressive symptoms.
- CBT was found to be the most efficacious in both direct and indirect comparisons.

## Abstract

Maternal depression is a significant public health concern that can adversely affect both mothers and their children. Although various psychotherapeutic interventions have been proposed, their relative comparative efficacy remains unclear. This network meta-analysis (NMA) aimed to evaluate and compare the efficacy of different psychotherapeutic interventions in reducing maternal depressive symptoms.

A systematic search was conducted in the Web of Science Core Collection (Science Citation Index Expanded and Social Sciences Citation Index) to identify randomized controlled trials (RCTs) published between 1 February 2021 and 1 February 2025. Eligible studies included mothers aged ≥ 18 years who were assessed for maternal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and received any form of psychotherapy. Data were extracted using a predefined format (PROSPERO ID: CRD420251010916). Random-effects models were used to perform the NMA in R, reporting mean differences (MD) with 95% confidence intervals (CIs) and P-scores.

A total of 8 RCTs involving 2,919 participants were included. Cognitive behavioral therapy (CBT) was the only intervention that showed a statistically significant reduction in depressive symptoms compared to treatment as usual (TAU) (MD = -3.22, 95%CI: -5.91 to -0.54; p = 0.019; P-score = 0.92). Other interventions showed trends toward improvement, but these were not statistically significant (p > 0.05).

CBT emerged as the most efficacious psychotherapeutic approach in both direct and indirect comparisons, supported by statistical evidence from the NMA.

This study provides comparative efficacy evidence to inform treatment guidelines for maternal depression.

CBT was the most efficacious intervention among the psychotherapeutic approaches examined.

Findings support prioritizing CBT in clinical care and future maternal mental health guidelines.