Abstract
Background: Mental disorders during pregnancy are common, with
long-lasting negative effects on mother and child. The combination with
psychosocial symptoms, barriers on population and healthcare level and
lack of long-term evidence make treatment challenging. To overcome this,
there is raising awareness for collaborative care.
Objectives: Review perinatal mental health interventions and
analyse the impact of collaborative care.
Search strategy: Two independent reviewers searched for RCT’s
in Pubmed, Embase and PsycINFO.
Selection criteria: Trials studying the effect of psychological
or pharmacological interventions on the mental health of pregnant women
with psychiatric and/or psychosocial symptoms.
Data collection and analysis: Two reviewers independently
abstracted data and assessed study quality and risk of bias. Each study
was scored on collaborative care criteria: multi-professional approach
to patientcare, structured management plan, scheduled patient
follow-ups, enhanced interprofessional communication.
Main results: 35 studies were included. Most trials studied the
effect of cognitive behavioural therapy and interpersonal psychotherapy
on perinatal depression. Almost all interventions met at least one
collaborative care criteria. Interventions were mostly provided by
multiple professionals, but interprofessional communication rarely took
place. Interventions that met more criteria did not more often show a
positive effect on maternal mental health.
Conclusions: There is lack of research on perinatal psychiatric
disorders other than depressive and on long-term treatment outcomes.
Collaborative care is partly implemented in most current interventions,
but more trials (including interprofessional communication) are needed
to be conclusive whether collaborative care is a key component in
perinatal mental healthcare.
Funding: None
Keywords: pregnancy, mental disorders, psychosocial,
collaborative care
Tweetable abstract: There is an important lack of evidence of
the role of collaborative care in perinatal mental healthcare