Efficacy of contextual therapies in perinatal depression and anxiety: A systematic review and meta-analysis

J Psychiatr Res. 2024 Jan:169:209-223. doi: 10.1016/j.jpsychires.2023.11.003. Epub 2023 Nov 20.

Abstract

Background: There are previous meta-analyses on the efficacy of cognitive behavioral therapy or mindfulness-based therapies in the perinatal period, but no previous review has focused on contextual therapies as a whole. The aim of this study was to carry out a systematic review and meta-analysis of the efficacy of contextual therapies on depressive and anxious symptoms in women in the perinatal period.

Methods: A systematic search for randomized clinical trials has been carried out in the PUBMED, CINAHL, Psyc-INFO and Cochrane Library search engines. For the quantitative synthesis, the Morris effect size measure has been used.

Results: A total of 34 RCTs have been found, of which 30 have been used for meta-analysis. The mean effect size of the studies on depression scores was dppc2 = -0.81 (95% CI = -1.12 to -0.50), while it was dppc2 = -1.04 (95% CI = -1.54 to -0.53) in the case of studies on anxiety scores. These effect sizes decreased to medium effect sizes when corrected for publication bias.

Limitations: The main limitations are the quality of the included studies, publication bias, and the limited number of studies on contextual therapies other than mindfulness-based therapies.

Conclusions: In conclusion, this systematic review found a large number of efficacy studies on mindfulness-based therapies and a small number of studies on the other contextual therapies. The effect sizes found are consistent with previous meta-analyses in the perinatal period.

Keywords: ACT; Behavioral activation; Contextual therapy; MBI.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Anxiety / psychology
  • Anxiety Disorders
  • Cognitive Behavioral Therapy*
  • Depression / diagnosis
  • Depression / therapy
  • Female
  • Humans
  • Mindfulness*
  • Pregnancy