Cognitive behavioural therapy (CBT)
Most included RCT’s (k=12) investigated the effect of CBT on antenatal
depression. Part of the studies (k=6) examined individual CBT (6-14
sessions) modified to pregnant women, focusing on the specific problems
these women were facing. Three pilot studies23,24,25found significantly lower levels of depressive or anxiety symptoms in
the CBT group compared to the care as usual group. Of the 3 larger
trials, one study26 found an intervention effect for
women with high depressive symptoms, one study27described no significant effect, and one study28showed a negative effect of CBT compared to usual care. The other 6
studies examined CBT modified to women with additional psychosocial
symptoms (e.g. low-income, minority group). Four
studies29,30,31,32, including two pilot
studies29,30, reported (significantly) lower
depressive symptoms in the CBT group compared to the care as usual
group. However, one of these study32 found a treatment
effect for high-risk African American women only and one study was not
powered to test for statistical significance. The other 2
studies,33,34 did not find a significant difference
between both groups.