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.