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A meta-analysis of treatments for perinatal depression
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This meta-analysis assessed efficacy of pharmacologic and psychological interventions for treatment of perinatal depression. A systematic review identified 27 studies, including open trials (n=9), quasi-randomized trials (n=2), and randomized controlled trials (n=16) assessing change from pretreatment to posttreatment or comparing these interventions to a control group. Uncontrolled and controlled effect sizes were assessed in separate meta-analyses. There was significant improvement in depressive symptoms from pretreatment to posttreatment, with an uncontrolled overall effect size (Hedges' g) of 1.61 after removal of outliers and correction for publication bias. Symptom levels at posttreatment were below cutoff levels indicative of clinically significant symptoms. At posttreatment, intervention groups demonstrated significantly greater reductions in depressive symptoms compared to control groups, with an overall controlled effect size (Hedges' g) of 0.65 after removal of outliers. Individual psychotherapy was superior to group psychotherapy with regard to changes in symptoms from pretreatment to posttreatment. Interventions including an interpersonal therapy component were found to have greater effect sizes, compared to control conditions, than interventions including a cognitive-behavioral component. Implications of the findings for clinical practice and future research are discussed.
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“Importantly, there is strong evidence that PMH conditions can be prevented52-54 and effectively treated through psychotherapy54-57 and/or pharmacotherapy.58,59”
From The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact (2022) · cites this paper as [55]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“It is important to recognize that in addition to pharmacologic treatment, interpersonal therapy (IPT) and cognitive behavioral therapy (CBT) interventions are the most well studied and most effective treatment85,86 and prevention strategies87 for perinatal mood disorders.”
From Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications: A Systematic Review and Meta-analysis (2021) · cites this paper as [86]
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“Existing reviews highlight the effectiveness of a number of interventions for PPD including medication (eg, antidepressant medication), health promotion interventions (eg, educational home visits) and psychological interventions (eg, cognitive–behavioural therapy (CBT) and interpersonal therapy.16–27”
From Effectiveness and acceptability of cognitive-behavioural therapy based interventions for maternal peripartum depression: A systematic review, meta-analysis and thematic synthesis protocol (2019) · cites this paper as [25]
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“Computer-based therapies may be most appealing to pregnant women who do not want to take medication or face barriers such as scheduling demands, access to transportation, or childcare.48,49”
From Pregnancy and the Acceptability of Computer-Based Versus Traditional Mental Health Treatments (2017) · cites this paper as [49]
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“Effective treatments for depression exist (Claridge 2014; De Crescenzo et al. 2014; Sockol et al. 2011; Stuart and Koleva 2014)”
From Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial (2015) · cites this paper as Sockol et al. 2011
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“Although there are mixed findings regarding the superiority of one type of psychological intervention over another,17 25 27”
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“several reviews have found CBT to be an effective psychological intervention for PPD.23 25 26 30”
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“Informed by the evidence that reduced self-compassion, increased self-criticism, and maladaptive beliefs about motherhood are associated with psychopathology during the perinatal period (Felder, Lemon, Shea, Kripke, & Dimidjian, 2016;Sockol & Battle, 2015;Sockol, Epperson, & Barber, 2011)”
From Acceptance and Commitment Therapy for perinatal mood and anxiety disorders: A feasibility and proof of concept study. (2020) · cites this paper as Sockol, Epperson, & Barber, 2011
Experimental — accuracy not yet measuredIn the citing paper
“In 2011, a meta-analysis of the efficacy of pharmacologic and psychological interventions found that IPT demonstrated higher effect sizes when compared to controls and was superior to CBT in PND treatment (higher effect sizes when compared to controls). The meta-analysis also showed that individual psychotherapy was superior to group psychotherapy when observing changes in symptoms from”
From Perinatal Depression: Challenges and Opportunities (2021) · cites this paper as [42]
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“However, no conclusion was made regarding pharmacological treatments because there were too few studies.(42) An updated 2018 meta-analysis showed that IPT was effective in reducing PND symptoms in both prevention and treatment studies.”
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“For example, in meta-analyses of the effectiveness of psychological interventions—typically Interpersonal Psychotherapy (IPT) or cognitive-behavioural therapy (CBT)—for depression during the antenatal or postnatal period, Sockol et al [17, 70] found large between-group effects of g = 0.96 for controlled studies of IPT…”
BackgroundInfluentialMacQUEEN, G. M., Frey, B. N., Ismail, Z., Jaworska, N., Steiner, M. S., Lieshout, R. J. V., Kennedy, S. H., Lam, R. W. M., Milev, R. V., Parikh, S. V., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659276 · Cited by 266
“mild to moderate depression, including CBT and IPT delivered in either individual or group format, is supported by meta-analyses.(54,55) Given the established efficacy of SSRIs as first-line treatments in MDD outside of the perinatal period, citalopram, escitalopram and sertraline are recommended based on efficacy and…”
MethodIntergenerational Effects of Childhood Trauma
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Perinatal Antidepressant Use: Understanding Women’s Preferences and Concerns
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“We recruited participants between October 2011 and February 2012 by advertisements on website banners, ‘new “Helping with Depression” treatment study’, on the UK Netmums parenting website front page and on their PND chat room page (www.netmums.co.uk), through the Netmums’ newsletter, via emails to women who had posted…”
ResultInfluentialComputer- or web-based interventions for perinatal mental health: a systematic review
Ashford, M. T., Olander, E. K., & Ayers, S. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.02.057 · Cited by 166
Perinatal Depression: An Update and Overview
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“This limitation was also noted by Sockol et al. (2011) [64].”
BackgroundA systematic review and meta-analysis of interpersonal psychotherapy for perinatal women
Sockol, L. E. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.01.018 · Cited by 158
Self-citationPreventing postpartum depression: A meta-analytic review
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“…interventions are modest compared to treatments for postpartum depression, which a previous meta-analysis found to be in the medium range (g = 0.65, Sockol et al., 2011), the efficacy of these interventions is comparable to, or exceeds, the efficacy of preventive interventions for anxiety and…”
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“Interpersonal psychotherapy (IPT) has been modified for treatment of antenatal depression in several studies (Sockol, 2011; Spinelli, 2013), and cognitive behavioral (CBT), supportive, and psychodynamic interventions have been investigated in small studies for the postpartum population,”
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“, role transitions, relational conflicts), may be more efficacious than CBT, which targets maladaptive depressogenic cognitions (Bledsoe and Grote, 2006; Sockol et al., 2011).”
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“Group-based psychotherapy interventions such as supportive psychotherapy have substantially less evidence to support their efficacy in pregnant women than individual psychotherapy interventions, such as interpersonal psychotherapy or cognitive-based therapy [36].”
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“There is some evidence that cognitive–behavioral therapy may not be as effective for perinatal depression as interpersonal psychotherapy (Sockol et al. 2011).”
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Self-citationA randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression
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“…therapy (IPT) alone or with antidepressant medications to be more effective than no psychotherapy, although not all studies were careful to limit enrollment to women with incident PMD and many included women with depression onset any time during the first postpartum year (Sockol et al. 2011).”
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A pilot randomised controlled trial of cognitive behavioural therapy for antenatal depression
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“There have been a number of studies which have shown psychological and psychosocial treatments to be effective in improving mood postnatally [19-21].”
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“Both are associatedwithmoderate to large reductions in PPD symptoms in controlled trials.(22,23) For patients with PPD who elect to forego formal psychotherapy or in areas where cognitivebehavioral therapy and IPT are unavailable, weaker evidence supports the use of nondirective counseling for short-term benefit, but…”
Psychological treatments for perinatal depression
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Interpersonal Psychotherapy for Postpartum Depression
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A systematic review of psychological treatments for clinical anxiety during the perinatal period
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“Interpersonal Psychotherapy (IPT) was noted to have greater effect sizes as compared to control groups in a meta-analysis on various treatments for perinatal depression (Sockol et al, 2011).”
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Interpersonal Psychotherapy to Reduce Psychological Distress in Perinatal Women: A Systematic Review
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“Cognitive behavioral therapy (CBT), interpersonal psychotherapy, and antidepressant medications have demonstrated benefit in preventing the onset of depressive symptoms [6,7].”
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“While some researchers report that women with higher baseline depressive symptoms improve less (Sockol et al., 2011), others report that women “at risk” for depression show greater symptom improvement post-treatment (Bittner et al.”
BackgroundPsychotherapies for adult depression: recent developments
Cuijpers, P. (2015) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000121 · Cited by 64
“Most studies on psychotherapy for depression have focused on adults in general, but there are also several dozens of studies showing that these psychotherapies are equally effective or about equally effective in older adults [18], in women with postpartum depression [19], and in depressed patients with a comorbid soma…”
BackgroundThe effect of music, massage, yoga and exercise on antenatal depression: A meta-analysis
Zhu, Y., Wang, R., Tang, X., Li, Q., Xu, G., & Zhang, A. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.05.122 · Cited by 68
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Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial
Goodman, J. H., Prager, J., Goldstein, R., & Freeman, M. (2015) · Archives of Women's Mental Health · doi:10.1007/s00737-014-0483-y · Cited by 64
“Effective treatments for depression exist (Claridge 2014; De Crescenzo et al. 2014; Sockol et al. 2011; Stuart and Koleva 2014); however, only about 12 to 25 % of depressed women receive treatment during the postpartum period (Goodman and Tyer-Viola 2010; Horowitz and Cousins 2006; Marcus et al.”
Fonseca, A., Ganho-Ávila, A., den Berg, M. P. L., Lupattelli, A., Muñoz, M. D. L. F. R., Ferreira, P. L., Radoš, S. N., & Bina, R. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.112 · Cited by 58
Toscano, M., Royzer, R., Castillo, D., Li, D., & Poleshuck, E. (2021) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000004335 · Cited by 60
Weisskopf, E., Fumeaux, C. J. F., Graz, M. B., Harari, M. M., Tolsa, J., Claris, O., Vial, Y., Eap, C. B., Csajka, C., & Panchaud, A. (2015) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2015.997708 · Cited by 52
“, couple or family) [28-31] as well as alternative therapies (i.”
BackgroundFurtado, M., Van Lieshout, R. J., Van Ameringen, M., Green, S. M., & Frey, B. N. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.02.064 · Cited by 50
Computer-assisted cognitive behavioral therapy for pregnant women with major depressive disorder
Kim, D. R., Hantsoo, L., Thase, M. E., Sammel, M., & Epperson, C. N. (2014) · Journal of Women's Health · doi:10.1089/jwh.2014.4867 · Cited by 42
Self-citationTsai, A. C., Tomlinson, M., Dewing, S., le Roux, I. M., Harwood, J. M., Chopra, M., & Rotheram‐Borus, M. J. (2014) · Archives of Women s Mental Health · doi:10.1007/s00737-014-0426-7 · Cited by 52
“Because perinatal depression is treatable (Sockol et al. 2011), its underdiagnosis represents a major missed public health opportunity.”
BackgroundRojas‐García, A., Ruíz-Pérez, I., Rodríguez‐Barranco, M., Gonçalves, D. C., Pastor‐Moreno, G., & Ricci‐Cabello, I. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.03.001 · Cited by 54
Waters, C. S., Annear, B., Flockhart, G., Jones, I., Simmonds, J. R., Smith, S., Traylor, C., & Williams, J. F. (2020) · British Journal of Clinical Psychology · doi:10.1111/bjc.12261 · Cited by 51
“…that have evaluated the effectiveness of group-delivered CBT and IPT for mild-moderate perinatal depressive symptoms (Dennis & Hodnett, 2007; Sockol et al ., 2011), and studies that have demonstrated the efficacy of ACT for mood and/or anxiety disorders outside of the perinatal period…”
BackgroundSingla, D. R., Lemberg-Pelly, S., Lawson, A., Zahedi, N., Thomas-Jacques, T., & Dennis, C. (2020) · JMIR Mental Health · doi:10.2196/19271 · Cited by 47
“Psychological interventions, including cognitive, behavioral, and interpersonal therapies, are effective in targeting common perinatal mental health issues such as depression and anxiety [5,6] and are preferred by women over pharmacological treatment [7,8].”
BackgroundSingla, D. R., Silver, R. K., Vigod, S. N., Schoueri‐Mychasiw, N., Kim, J., Porte, L. M. L., Ravitz, P., Schiller, C. E., Lawson, A., Kiss, A., et al. (2025) · Nature Medicine · doi:10.1038/s41591-024-03482-w · Cited by 52
“Brief psychothera-pies are first-line, evidence-based treatments 4,5 .”
Claridge, A. M. (2014) · Archives of Women's Mental Health · doi:10.1007/s00737-013-0391-6 · Cited by 44
“Based on recent meta-analyses (Bledsoe and Grote 2006; Sockol et al. 2011), the treatment with the most evidence thus far is interpersonal psychotherapy, followed closely by cognitive behavioral therapy.”
BackgroundResultInfluentialEustis, E. H., Ernst, S., Sutton, K., & Battle, C. L. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1121-1 · Cited by 45
Ashford, M. T., Olander, E. K., Rowe, H., Fisher, J. R., & Ayers, S. (2018) · JMIR Mental Health · doi:10.2196/mental.9106 · Cited by 45
“Despite available effective treatments [6-10], postpartum mental health problems often go undetected or untreated [11,12].”
A systematic review of depression psychotherapies among Latinos
Collado, A., Lim, A. C., & MacPherson, L. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.04.001 · Cited by 49
Pharmacologic Treatment of Perinatal Depression
Kimmel, M., Cox, E., Schiller, C. E., Gettes, E., & Meltzer-Brody, S. E. (2018) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2018.04.007 · Cited by 48
Yan, H., Wu, Y., & Li, H. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.03.002 · Cited by 50
Mood and Anxiety Disorders in Pregnant and Postpartum Women
(2015) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/1552-6909.12734 · Cited by 41
Pettman, D., O'Mahen, H., Skoog Svanberg, A., von Essen, L., Axfors, C., Blomberg, O., & Woodford, J. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-032659 · Cited by 24
Clinkscales, N., Golds, L., Berlouis, K., & MacBeth, A. (2023) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12441 · Cited by 41
Perinatal anxiety: approach to diagnosis and management in the obstetric setting
Thorsness, K. R., Watson, C., & LaRusso, E. M. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2018.05.017 · Cited by 45
Singla, D. R., Meltzer-Brody, S. E., Silver, R. K., Vigod, S. N., Kim, J. J., Porte, L. M. L., Ravitz, P., Schiller, C. E., Schoueri‐Mychasiw, N., Hollon, S. D., et al. (2021) · Trials · doi:10.1186/s13063-021-05075-1 · Cited by 39
“Psychological treatments, such as cognitive, behavioral, and interpersonal therapies, are first-line, effective interventions for perinatal depression and anxiety [11, 12] and are preferred by many women over pharmacotherapy [13, 14].”
BackgroundKingston, D. E., Austin, M., Hegadoren, K., McDonald, S., Lasiuk, G. C., McDonald, S. D., Heaman, M. I., Biringer, A. B., Sword, W. A., Giallo, R., et al. (2014) · Trials · doi:10.1186/1745-6215-15-72 · Cited by 39
O’Hara, M. W., Pearlstein, T. B., Stuart, S. P., Long, J. D., Mills, J. A., & Zlotnick, C. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.10.361 · Cited by 39
Management of perinatal depression with non-drug interventions
Johansen, S. L., Robakis, T. K., Williams, K. E., & Rasgon, N. (2019) · BMJ · doi:10.1136/bmj.l322 · Cited by 41
Reuveni, I., Lauria, M., Monk, C. E., & Werner, E. A. (2020) · Archives of Women s Mental Health · doi:10.1007/s00737-020-01066-4 · Cited by 38
Stewart, A. L., & Payne, J. L. (2023) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2023.04.003 · Cited by 48
Ashford, M. T., Ayers, S., & Olander, E. K. (2017) · Health & Social Care in the Community · doi:10.1111/hsc.12428 · Cited by 36
Alhusen, J. L., Hayat, M. J., & Borg, L. E. (2020) · Archives of Women's Mental Health · doi:10.1007/s00737-020-01032-0 · Cited by 38
Leung, S. S. K., & Lam, T. (2012) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2012.06.014 · Cited by 37
Childhood Mental and Developmental Disorders
Scott, J. G., Mihalopoulos, C., Erskine, H. E., Roberts, J., & Rahman, A. (2016) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0426-7_ch8 · Cited by 39
Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings
Olin, S.-C. S., McCord, M., Stein, R. E. K., Kerker, B. D., Weiss, D., Hoagwood, K., & Horwitz, S. M. (2017) · Journal of Women s Health · doi:10.1089/jwh.2016.6089 · Cited by 34
“Mothers should be informed about the efficacy of psychosocial and pharmacotherapy treatments, both of which are effective in reducing depressive symptoms.(42,75,76) Options for follow-up care should be discussed and decisions based on various factors, including maternal preference and available competency within the p…”
Attention-deficit/hyperactivity disorder in pregnancy and the postpartum period
Scoten, O. C., Tabi, K., Paquette, V., Carrion, P. B., Ryan, D. M., Radonjić, N. V., Whitham, E. A., & Hippman, C. (2024) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2024.02.297 · Cited by 38
An open-label pilot study of a home wearable light therapy device for postpartum depression
Swanson, L. M., Burgess, H. J., Zollars, J. W., & Arnedt, J. T. (2018) · Archives of Women s Mental Health · doi:10.1007/s00737-018-0836-z · Cited by 32
“65 from a meta-analysis of treatments (psychotherapy and medication) for perinatal depression (Sockol et al. 2011).”
InfluentialTrevillion, K., Ryan, E., Pickles, A. R., Heslin, M., Byford, S., Nath, S., Bick, D., Milgrom, J., Mycroft, R. H., Domoney, J., et al. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.10.013 · Cited by 39
“interventions for one of the most common disorders - mild to moderate depression (Sockol et al., 2011).”
BackgroundPregnancy and the Acceptability of Computer-Based Versus Traditional Mental Health Treatments
Hantsoo, L., Podcasy, J., Sammel, M., Epperson, C. N., & Kim, D. R. (2017) · Journal of Women's Health · doi:10.1089/jwh.2016.6255 · Cited by 27
“48,49 A large number of participants cited the ability to access therapy at any time as being an important consideration for them.”
BackgroundSelf-citation
Metadata
- Authors
- Sockol, L. E., Epperson, C. N., & Barber, J. P.
- Affiliations
- University of Pennsylvania (US)
- Philadelphia VA Medical Center (US)
- Corresponding author
- Sockol, Laura E.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 31
- Issue
- 5
- Pages
- 839-849
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC4108991
- OpenAlex
- W2005817233
- Cited by
- 287
- References
- 83
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 12 · 2023: 21 · 2022: 14 · 2021: 30 · 2020: 22 · 2019: 16 · 2018: 21 · 2017: 18 · 2016: 20 · 2015: 26 · 2014: 22 · 2013: 32 · 2012: 8
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K24DA030301)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- perinatal depression, pharmacotherapy, psychological intervention, individual psychotherapy, group therapy, interpersonal psychotherapy, cognitive behavioral therapy, depressive symptom reduction, treatment efficacy
- MeSH terms
- Antidepressive Agents, Depressive Disorder, Female, Humans, Psychotherapy, Treatment Outcome, Depression, Postpartum, Peripartum Period
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