Abstract
BackgroundPostpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions.MethodsAn electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD.ResultsOf the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, − 0.09 to 0.34), or source of funding (p = 0.19).ConclusionOverall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.
Highlights
Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond
Numerous systematic reviews describing therapeutic interventions for the management of postpartum depression (PPD) have emerged in the literature in recent years; the most effective therapeutic options remain poorly defined
The aim of this study was to evaluate the quality of systematic reviews on the efficacy and safety of different PPD interventions using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool and to evaluate different therapeutic strategies stratified by methodological quality
Summary
Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. Though there are many concerns for the mother after parturition, emergence of postpartum depression (PPD) and clinical management strategies remain an important unresolved issue [1]. PPD is defined by the Diagnostic and Statistical Manual of Mental Disorders IV and is an increasingly prevalent mental health problem that typically begins four to six weeks after parturition [2]. PPD is a complex disorder whose pathophysiology remains poorly defined with sub-optimal therapeutic options and an expanding literature. Numerous systematic reviews describing therapeutic interventions for the management of PPD have emerged in the literature in recent years; the most effective therapeutic options remain poorly defined
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