Archives of Women's Mental Health

, Volume 17, Issue 1, pp 3–15

Efficacy of systemically oriented psychotherapies in the treatment of perinatal depression: a meta-analysis

Review Article

Abstract

The objective of this meta-analysis was to examine the efficacy of systemically oriented psychotherapy treatments for depression in pregnancy and the postpartum. Specifically, this synthesis examined standardized mean differences between pre- and posttest and treatment-control conditions in depression symptom reduction among 24 individual interpersonal psychotherapy or relational psychotherapy studies completed between 1997 and 2013. Analyses assessed heterogeneity, potential moderators, and publication bias. Random-effects analyses revealed a large, positive average effect size \( \left(\overline{d}=1.14\right) \) for psychotherapy treatments among one-group, pre–post-studies and a medium, positive average effect \( \left(\overline{d}=0.40\right) \) when treatments were compared with control groups. Mixed-effects meta-ANOVAs indicated that treatment type, participant depression severity, and method of depression assessment were significant moderators such that effect sizes were larger among individual interpersonal psychotherapy studies, clinical samples, and studies that included an independent evaluation of depression. However, relational treatments and studies with nonclinical samples were less represented in the literature, and still demonstrated small to medium positive effects. Meta-regressions revealed that effects were largest when treatments were delivered with adherence fidelity checks and over more sessions. Based on funnel plots and Egger tests, there was evidence of publication bias in this analysis; however, the effects were distributed fairly symmetrically about the mean given the relatively small number of available studies. Findings have implications for continued examination of systemically oriented psychotherapy treatments for depression in pregnancy and the postpartum.

Keywords

Depression Meta-analysis Relational treatment Postpartum Pregnancy Psychotherapy 

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  1. 1.Department of Family and Child Sciences, College of Human SciencesThe Florida State UniversityTallahasseeUSA

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