Optimizing cognitive and behavioral approaches for perinatal depression: A systematic review and meta-regression analysis

Waqas, Ahmed ORCID: 0000-0002-3772-194X, Zafar, Syeda Wajeeha, Akhtar, Parveen, Naveed, Sadiq and Rahman, Atif ORCID: 0000-0002-2066-4467
(2023) Optimizing cognitive and behavioral approaches for perinatal depression: A systematic review and meta-regression analysis. CAMBRIDGE PRISMS-GLOBAL MENTAL HEALTH, 10. e22-.

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Cognitive behavioral therapies (CBT) have been demonstrated efficacious in treating perinatal depression (PND). This has been demonstrated in several meta-analyses of randomized controlled trials and quasi-experimental studies. However, there is a need for up-to-date meta-analytical evidence providing reliable estimates for CBT's effectiveness in treating and preventing PND. Furthermore, with the world moving toward precision medicine, approaches require a critical synthesis of psychotherapies, especially to unpack their mechanisms of action and to understand what approaches work best for whom. Therefore, the present systematic review and meta-regression analyses aim to answer these research questions. We searched six academic databases through February 2022 and identified 56 studies for an in-depth review. Using pretested data extraction sheets, we extracted patient-level and intervention-level characteristics and effect size data from each study. Random-effects meta-analyses and mixed-effect subgroup analyses were run to delineate the effectiveness and moderators of CBT interventions for PND, respectively. CBT-based interventions yielded a strong effect size (SMD = -0.74, 95% confidence interval [CI]: -0.91 to -0.56, <i>n</i> = 9,722) in alleviating depressive symptoms. These interventions were effective across different delivery formats (individual, group, and electronic) and could be delivered effectively by specialists and nonspecialists. Longer duration CBT interventions may not necessarily be more effective than shorter ones. Moreover, CBT-based interventions should consider including various behavioral ingredients to maximize intervention benefits.

Item Type: Article
Uncontrolled Keywords: cognitive behavioral therapy, CBT, perinatal depression
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 19 Apr 2023 09:01
Last Modified: 21 Oct 2023 02:39
DOI: 10.1017/gmh.2023.8
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3169728