Review Compares Psychological Therapies for Perinatal Depression

CBT, behavioral activation, interpersonal therapy may be effective compared with treatment as usual

By Elana Gotkine HealthDay Reporter

FRIDAY, Nov. 7, 2025 (HealthDay News) — Cognitive behavioral therapy (CBT), behavioral activation, and interpersonal therapy (IPT) may be effective for perinatal depression, according to a systematic review and meta-analysis published online Nov. 4 in the Annals of Internal Medicine.

Elyse Couch, Ph.D., from the Brown University School of Public Health in Providence, Rhode Island, and colleagues evaluated psychological therapies for perinatal depression using data from randomized controlled trials (RCTs) of psychological therapies for people with depression during pregnancy and up to one year postpartum. Data were included from 44 RCTs.

The researchers found that compared with treatment as usual (TAU), CBT was probably more effective for reducing depressive symptoms by an equivalent −1.7 points on the Edinburgh Postnatal Depression Scale (EPDS) and may have greater recovery rates from depressive symptoms (relative risk, 1.7). For reducing depressive symptoms, behavioral activation may be more effective than TAU by an equivalent −1.5 EPDS points. No differences appear to exist between CBT and counseling or TAU and counseling. Compared with TAU, interpersonal therapy was probably more effective in reducing depressive symptoms by an equivalent −1.7 EPDS points and may have greater recovery rates from depressive symptoms (relative risk, 1.2).

“CBT, behavioral activation, and IPT may be more effective overall than TAU for treating perinatal depression; however, the improvement in depressive symptoms may not constitute a clinically meaningful difference,” the authors write.