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A meta-analysis of treatments for perinatal depression
Open accessAbstract
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]
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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“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
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“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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Citations
Cites
Measuring inconsistency in meta-analyses
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Pharmacological interventions for somatoform disorders in adults
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Cognitive Therapy for Depression
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Rosenthal, R. (1979) · Psychological Bulletin · doi:10.1037/0033-2909.86.3.638 · Cited by 9,068
Distribution Theory for Glass's Estimator of Effect Size and Related Estimators
Hedges, L. V. (1981) · Journal of Educational Statistics · doi:10.2307/1164588 · Cited by 5,695
Cognitive Therapy of Depression
HOLLON, S. D., & BECK, A. T. (1979) · Cognitive-Behavioral Interventions · doi:10.1016/b978-0-12-404480-7.50012-5 · Cited by 4,685
Meta-Analytic Procedures for Social Research
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Cochrane Database of Systematic Reviews
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Cited by
Sorted by citations
The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9476-1 · Cited by 3,445
Postpartum depression: current status and future directions
O'Hara, M. W., & McCabe, J. E. (2013) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050212-185612 · Cited by 1,750
“…the average effect size of active treatment compared to control conditions (both excluding the same outlier study) [Cohen’s d = 0.51, 95% CI = 0.34–0.68, p < 0.001 (Cuijpers et al. 2008) and Hedges’ g = 0.57, 95% CI = 0.38–0.75, p < 0.001 (L.E. Sockol, personal communication; Sockol et al. 2011)].”
BackgroundInfluentialRogers, A., Obst, S., Teague, S. J., Rossen, L., Spry, E. A., Macdonald, J. A., Sunderland, M., Olsson, C. A., Youssef, G., & Hutchinson, D. (2020) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2020.2910 · Cited by 620
O’Connor, E., Rossom, R. C., Henninger, M., Groom, H. C., & Burda, B. U. (2016) · JAMA · doi:10.1001/jama.2015.18948 · Cited by 563
Sockol, L. E. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.01.052 · Cited by 395
“Previous meta-analytic reviews of interventions for perinatal depression have found that CBT is effective for the treatment (Cuijpers et al., 2008; Sockol et al., 2011) and prevention (Sockol et al., 2013) of these disorders.”
BackgroundMethodResultInfluentialSelf-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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