Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials

Clin Psychol Rev. 2022 Mar:92:102129. doi: 10.1016/j.cpr.2022.102129. Epub 2022 Jan 25.

Abstract

Cognitive behavioral therapy (CBT) has been widely studied in prenatal or postnatal depression, with much less research on anxiety and stress. This meta-analysis aims to comprehensively evaluate CBT efficacy for perinatal depression, anxiety and stress in the short term (from baseline to immediately post-intervention) and in the long term (from baseline to the end of follow-up). Five databases were searched. We included 79 randomized controlled trials (RCTs) and quasi-RCTs assessing the efficacy of CBT during pregnancy and the first year postpartum. Primary outcome was the mean score change in depression, anxiety and stress. CBT-only and CBT plus other interventions were effective for perinatal maternal depression in the short term (SMD -0.69, 95% CI: -0.83, -0.55) and long term (SMD -0.59, 95% CI -0.75, -0.42). CBT-only had both short- and long-term efficacy for perinatal anxiety (short term: SMD -0.63, 95% CI -0.85, -0.42; long term: SMD -0.71, 95% CI -1.02, -0.39) and short-term efficacy for perinatal stress (SMD -0.96, 95% CI -1.40, -0.52). Overall, CBT was effective for perinatal maternal depression, anxiety and stress. CBT-only exhibited short-term efficacy for perinatal depression, anxiety and stress, and long-term efficacy for perinatal depression and anxiety. Subgroup analyses suggested that CBT-only was effective across a wide variety of modalities.

Keywords: Anxiety; Cognitive behavioral therapy; Depression; Meta-analysis; Perinatal; Stress.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anxiety / therapy
  • Anxiety Disorders / therapy
  • Cognitive Behavioral Therapy*
  • Depression* / therapy
  • Female
  • Humans
  • Randomized Controlled Trials as Topic

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