Effectiveness of Psychological Interventions for Postnatal Depression in Primary Care: A Meta-Analysis
Open accessAbstract
PURPOSE: Postnatal depression affects 10% to 15% of new mothers, and approximately 90% of cases are managed in primary care. Antidepressants are effective, but adherence is poor; therefore, psychological interventions must be investigated. In this systematic review, we assessed the efficacy of psychological therapies for postnatal depression in primary care. METHODS: We undertook a systematic search to identify articles published in English between 2000 and 2014 that reported studies meeting our eligibility criteria: (1) had a randomized controlled trial design; (2) assessed psychological interventions for postnatal depression against any other treatment or a wait-list control; (3) recruited patients in primary care; and (4) enrolled mothers with a diagnosed depressive episode or a score of at least 12 on the Edinburgh Postnatal Depression Scale or at least 10 on the Beck Depression Inventory at baseline who had a child younger than 12 months. Quality was assessed using an adapted Cochrane Collaboration Depression, Anxiety, and Neurosis (CCDAN) quality rating scale, and meta-analysis was carried out using RevMan 5.3 (The Cochrane Collaboration). RESULTS: Screening of 5,919 articles identified 10 studies that met inclusion criteria. These studies reported on 14 psychological intervention arms: 7 using cognitive behavioral therapy, 2 using interpersonal therapy, 2 using counseling, and 3 using other interventions. Psychological interventions resulted in lower depressive symptomatology than control both immediately after treatment (standardized mean difference = -0.38; 95% CI, -0.49 to -0.27) and at 6 months of follow-up (standardized mean difference =-0.21; 95% CI, -0.37 to -0.05). We did not find any significant differences between the various types of therapy. Compared with control, the interventions also led to improvements in adjustment to parenthood, marital relationship, social support, stress, and anxiety. CONCLUSIONS: Psychological interventions deliverable in the primary care setting are associated with a significant improvement in depressive symptomatology both immediately after completion and for up to 6 months of follow-up.
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There are mixed findings regarding the superiority of one type of psychological intervention over another for peripartum depression.
“Although there are mixed findings regarding the superiority of one type of psychological intervention over another,17 25 27”
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- Authors
- Stephens, S., Ford, E., Paudyal, P., & Smith, H.
- Affiliations
- Brighton and Sussex Medical School (GB)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2016-09-01
- Volume
- 14
- Issue
- 5
- Pages
- 463-472
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC5394369
- OpenAlex
- W2394300255
- Cited by
- 109
- References
- 65
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 14 · 2023: 10 · 2022: 15 · 2021: 25 · 2020: 11 · 2019: 10 · 2018: 4 · 2017: 2 · 2016: 5
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- Figshare (submittedVersion)
- 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
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- postpartum depression, psychological intervention, primary care, cognitive behavioral therapy, interpersonal psychotherapy, counseling, maternal mental health, depressive symptoms, marital relationships, social support, anxiety
- MeSH terms
- Female, Humans, Primary Health Care, Psychiatric Status Rating Scales, Psychotherapy, Randomized Controlled Trials as Topic, Treatment Outcome, Depression, Postpartum
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