Main findings
The aim of this study was to give a systematic overview of all current
perinatal mental health interventions and to describe the role of
collaborative care. The current available interventions are almost all
either evidence-based or multidisciplinary, which means almost all
studies met at least one collaborative care criterion. Interventions
with a higher collaborative care score did not more often show a
positive effect on maternal mental health.
Almost all included trials (n=28) focused on treating women at risk of a
depressive disorder. CBT and IPT were the most studied interventions.
Both therapies were predominantly effective in reducing psychiatric
symptoms. The effects of other interventions are each based on a few
trials with small numbers of participants. Potentially beneficial
interventions are mindfulness-based therapy (3 trials), multicomponent
treatment (2 trials), psychoeducation (2 trials) and behavioural
activation (1 trial). The results of the few studies on tocophobia and
insomnia showed promising findings in reducing depressive symptoms and
symptoms of fear.
Although we could not find a clear effect of the CCS on maternal mental
health, we did find that a multi-professional approach to patientcare
could be essential in the treatment of pregnant women with psychiatric
and psychosocial symptoms. Almost all interventions with a positive
effect on maternal mental health and all studies with high retention
(> 90%) and compliance (> 60%)
rates met this criterion. Interventions provided by a multi-professional
team consisting of more than 2 different professionals (>
gynaecologist/midwife and a mental health therapist) were rare, as well
as interprofessional communication which was the least scored criterion.