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.