A systematic review of psychological treatments for clinical anxiety during the perinatal period
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Maternal anxiety is common during the perinatal period, and despite the negative outcomes of anxiety on the mother and infant, its treatment has received limited attention. This paper describes the first review of psychological interventions for clinical anxiety during the perinatal period. A systematic search was carried out of six electronic databases. Five studies which evaluated psychological interventions for clinical anxiety in perinatal women were identified. Of the five studies included, four were open trials and one was a randomised controlled trial. Three studies evaluated group-based interventions; one study evaluated an online-delivered intervention; and one study a combined pharmacologic-psychological intervention. All participants demonstrated significant reductions in anxiety symptom severity from pre- to post-treatment. However, this review was limited to published literature evaluating treatments for clinical anxiety in perinatal women, which may have excluded important intervention studies and prevention programs, and unpublished literature. This review identifies an area of research that needs urgent attention, as very few studies have evaluated psychological treatments for perinatal anxiety. The studies included in this review demonstrate that symptoms of anxiety during the perinatal period appear to improve during treatment. Future research is needed to establish the efficacy of perinatal anxiety interventions in randomised controlled trials, whether reductions persist long term and whether benefits extend to other outcomes for the mother, infant and family.
KeywordsPerinatal Pregnancy Antenatal Postpartum Postnatal Anxiety
SL, JN and GA designed the study and wrote the protocol and search strategy. SL, MW, AJ and HH conducted the searches, screened the titles, abstracts and full-texts for eligibility for inclusion. SL extracted the data from manuscripts, independently checked by MW, and conducted the data analysis with supervision from JN. All authors contributed to and have approved the final version of the manuscript for publication.
This study was supported by the Australian Rotary Health and the David Henning Memorial Foundation in the form of a PhD scholarship awarded to Siobhan Loughnan. Rotary Health Australia and the David Henning Memorial Foundation had no role in the study design, collection, data analysis or interpretation of the data, writing the manuscript or the decision to submit the paper for publication.
Compliance with ethical standards
The protocol was developed according to the Cochrane Handbook for Systematic Reviews of Interventions (Higgins and Green 2011), was registered with PROSPERO [CRD42017052446] and followed the PRISMA guidelines (Moher et al. 2009).
Conflict of interest
The authors declare that they have no conflict of interest.
- Post and Antenatal Depression Association (2012) The cost of perinatal depression in Australia. Deloitte Access Economics Pty Ltd, CanberraGoogle Scholar
- Ayers S, Coates R, Matthey S (2015) Identifying perinatal anxiety, First edn. Wiley, West SussexGoogle Scholar
- Beck AT, Steer RA (1996) Beck anxiety inventory. The Psychological Corporation, San AntonioGoogle Scholar
- Bittner A, Peukert J, Zimmermann C, Junge-Hoffmeister J, Parker LS, Stobel-Richter Y, Weidner K (2014) Early intervention in pregnant women with elevated anxiety and depressive symptoms: efficacy of a cognitive-behavioral group program. J Perinat Neonatal Nurs 28(3):185–195. https://doi.org/10.1097/JPN.0000000000000027 CrossRefPubMedGoogle Scholar
- FirstMB,GibbonM (2004) The structured clinical interview for DSM-IV Axis I Disorders (SCID-I) and the structured clinical interview for DSM-IV Axis II Disorders (SCID-II)Google Scholar
- Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32(1):50–55. https://doi.org/10.1111/j.2044-8341.1959.tb00467.x CrossRefPubMedGoogle Scholar
- Higgins J, GreenSM (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. Retrieved fromwww.handbook.cochrane.org
- MilgromJ, DanaherBG, GemmillAW, HoltC, HoltCJ, SeeleyJR, …EricksenJ (2016) Internet cognitive behavioral therapy for women with postnatal depression: a randomized controlled trial of Mum Mood Booster. J Med Internet Res 18(3)Google Scholar
- Muzik M, Rosenblum KL, Alfafara EA, Schuster MM, Miller NM, Waddell RM, Kohler ES (2015) Mom power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers. Arch Women’s Mental Health 18(3):507–521. https://doi.org/10.1007/s00737-014-0490-z CrossRefGoogle Scholar
- Spielberger CD, Gorsuch RL, Lushene PR, Vagg PR, Jacobs AG (1970) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo AltoGoogle Scholar
- Stewart RE, Chambless DL (2009) Cognitive–behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. American Psychological Association, Washington, D.C.Google Scholar