Article

A meta-analysis of treatments for perinatal depression

Department of Psychology, University of Pennsylvania, United States.
Clinical psychology review (Impact Factor: 7.18). 07/2011; 31(5):839-49. DOI: 10.1016/j.cpr.2011.03.009
Source: PubMed

ABSTRACT

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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    • "A recent meta-analysis shows that existing treatments for PPD result in clinically significant reductions in depressive symptoms [88]. IPT was found to be superior to CBT for treating PPD, and individual treatments produced greater symptom reduction than group treatments [88]. Despite the substantial evidence of symptom reduction following PPD treatment, evidence for improved child outcomes following effective treatment for PPD is lacking [89]. "

    No preview · Article · Feb 2016
    • "A recent trial was conducted that evaluated the development and implementation of a peer-support telephonebased programme (Dennis, 2014). The trial involved telephone contact provided by volunteers to new mothers following discharge from hospital, safety such as car seat compliance (Sockol et al, 2011). Postnatal depression can have fatal ramifications and is associated with high rates of maternal suicide and, more rarely, infanticide (Miller et al, 2013). "
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    ABSTRACT: Depression is a condition that affects millions of people worldwide and is the highest cause of disease burden affecting women. Postnatal depression affects up to 25% of all childbearing women; however its prevalence is often under detected and underdiagnosed. Early screening and early intervention are integral in the prevention of postnatal depression. Preventive interventions focus on the efficacy of omega three supplements, physical activity and placentophagy practices. However there is promising evidence regarding the efficacy of antidepressant therapy, increased social support, and technological based psychological interventions, in the prevention of postnatal depression. The purpose of this paper is to provide midwifery students, newly qualified graduates and midwives an opportunity to develop and up-date their skills and knowledge.
    No preview · Article · Feb 2015 · British Journal of Midwifery
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    • "Wisner et al., 2009) might improve maternal disorders and offspring outcomes, but during pregnancy and lactation potential risks and benefits have to be evaluated (Arch et al., 2012; Bonari et al., 2004; Wisner et al., 2009). Psychotherapies involving the family and interventions designed to improve mother-infantinteraction are promising strategies that need further research attention (Sockol et al., 2011; Stein et al., 2014). "
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    ABSTRACT: Peripartum anxiety and depressive disorders are associated with adverse consequences for mother and child. Thus, it is important to examine risk factors, correlates and course patterns of anxiety and depressive disorders during pregnancy and after delivery. In the prospective-longitudinal Maternal Anxiety in Relation to Infant Development (MARI) Study, n=306 expectant mothers were recruited from gynaecological outpatient settings in Germany and completed up to seven waves of assessment from early pregnancy until 16 months postpartum. Anxiety and depressive disorders and potential risk factors/correlates were assessed with the Composite International Diagnostic Interview for Women (CIDI-V), medical records and additional questionnaires. Although peripartum anxiety and depressive disorders appeared to be persistent in some women, others reported major changes with heterogeneous courses and shifts between diagnoses and contents. There was a considerable amount of incident disorders. Strongest predictors for peripartum anxiety and depressive disorders were anxiety and depressive disorders prior to pregnancy, but psychosocial (e.g. maternal education), individual (e.g. low self-esteem), and interpersonal (e.g. partnership satisfaction, social support) factors were also related. Knowing the aims of the study, some participants may have been more encouraged to report particular symptoms, but if so, this points to the importance of a comprehensive assessment in perinatal care. Peripartum time is a sensitive period for a considerable incidence or persistence/recurrence of anxiety and depressive disorders albeit the course may be rather heterogeneous. Interventional studies are needed to examine whether an alteration of associated factors could help to prevent peripartum anxiety and depressive disorders. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Jan 2015 · Journal of Affective Disorders
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