Abstract
Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.
Highlights
We summarize the results of our recent meta-analysis on these studies (Cuijpers et al 2021a, b)
We recently conducted a meta-analysis of all randomized controlled trials on psychological treatments of perinatal depression based on an existing database of trials on psychotherapies for depression in general (Cuijpers et al 2021a, b)
This effect was, significantly smaller than the effects of therapy in patients with a major depressive disorder. This is not surprising in itself, because the level of depressive symptoms is low from the start in subthreshold depression, and there is less room for improvement. In this meta-analysis, we found that psychotherapies aimed at subthreshold depression have a significant effect on the incidence of major depressive episodes at 6-month follow-up and possibly at 12 months (RR = 0.74)
Summary
Depression during pregnancy and after the birth of an infant is highly prevalent and is associated with a considerable reduction in quality of life, social functioning In our previous work, we found that the effects of psychological treatments of perinatal depression do not considerably differ from treatments in other populations (e.g., adults in general) (Cuijpers et al 2018). This means that lessons learned from research on psychotherapies in general are valid in the case of perinatal depression. In the present paper, next to summarizing our perinatal depression meta-analysis findings, we summarize the results of a series of meta-analyses of psychotherapies for adult depression in general conducted by our group over the past 15 years (Cuijpers 2017; www.metapsy.org). We examine different types of psychotherapy, their format, number of sessions, subtypes of depression, longer-term effects, and effects on other outcomes than depression (e.g., parental and marital distress)
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