Psychotherapies Outperform Usual Care for Perinatal Depression: Study
A new study published in the journal of the Annals of Internal Medicine showed that when it came to treating perinatal depression, cognitive behavioral therapy, behavioral activation, and interpersonal therapy were superior to standard care.
Depression during pregnancy and the first year after childbirth is a serious public health problem, harming both mother well-being and early infant development. Psychological treatments have become crucial to therapy because they offer safe, non-pharmacological choices during a period when pharmaceutical usage may be limited by safety concerns. Approaches like cognitive behavioral therapy, interpersonal therapy, and behavioral activation attempt to develop coping abilities, manage interpersonal stresses, and improve everyday functioning.
Growing research demonstrates these therapies can considerably reduce depression symptoms and enhance long-term emotional wellness. Understanding which therapies work best is vital for improving care for women throughout the perinatal period. Therefore, this study examined psychological therapy for prenatal depression. This research focused on RCTs which assessed psychological therapy for people experiencing depression during pregnancy and up to a year postpartum, encompassed 6 large databases from January 2000 to March 2025.
Analysis was done on 44 RCTs. Cognitive behavioral therapy (CBT; k = 25, n = 2962) was likely to be more effective than treatment as usual (TAU), lowering Edinburgh Postnatal Depression Scale (EPDS) scores by about −1.7 points (95% CI, −2.0 to −1.3; moderate certainty) and possibly boosting recovery rates (RR 1.7, CI 1.3 to 2.3; low certainty). Behavioral activation (k = 3, n = 508) may also outperform TAU, lowering symptoms by around −1.5 EPDS points (CI −2.6 to −0.5; poor confidence).
There was little (low confidence) variation in depressed outcomes between counseling and TAU (k = 3, n = 247; EPDS −0.8, CI −2.6 to 1.0) and between CBT and counseling (k = 3, n = 226; EPDS −0.5, CI −1.5 to 0.5). Interpersonal treatment (IPT; k = 9, n = 1003) was probably better to TAU, increasing EPDS scores by −1.7 points (CI −2.9 to −0.5; moderate certainty) and may marginally enhance recovery rates (RR 1.2, CI 0.97 to 1.5; medium certainty).
Overall, for addressing perinatal depression, behavioral activation, cognitive behavioral therapy, and interpersonal therapy have considerable therapeutic potential, with this study showing they can lower symptom intensity and enhance overall emotional recovery during pregnancy and the postpartum period.
Source:
Couch, E., Mai, H. J., Kanaan, G., Caputo, E. L., Lewis, O., Zahradnik, M. L., Howard, M., Bohlen, L. C., Konnyu, K., & Balk, E. M. (2025). Effectiveness of psychological therapies for depression during the perinatal period : A systematic review and meta-analysis. Annals of Internal Medicine. https://doi.org/10.7326/ANNALS-24-03520
