Effect of digital cognitive behavioral therapy on psychological symptoms among perinatal women in high income-countries: A systematic review and meta-regression

The Efficacy of Digital Cognitive–Behavioral Interventions in Supporting the Psychological Adjustment and Sleep Quality of Pregnant Women with Sub-Clinical Symptoms: A Systematic Review and Meta-Analysis

“…The interventions’ efficacy in terms of the anxiety symptoms is in line with the previous evidence on the efficacy of in-person CBTs for perinatal anxiety symptoms [ 40 ]. Similarly, the interventions’ efficacy in terms of the depression symptoms is consistent with the findings of a recent meta-analysis focused on digital CBTs administered to perinatal women [ 41 ] and a systematic review based on digital CBTs deployed to pregnant women [ 42 ]. However, both papers included studies regardless of the women’s psychological symptom level.…”

“…However, both papers included studies regardless of the women’s psychological symptom level. Moreover, akin to Lau and colleagues’ results [ 41 ], the current meta-analysis showed that the efficacy in terms of the depression symptoms was not maintained at follow-up during the postpartum period. Notwithstanding, it should be noted that the focus on depression symptoms compared to the scarce consideration of the highly associated anxiety and stress symptoms, as well as sleep quality and quality of life, represents a limitation of the available literature [ 50 ].…”

“…Previous reviews and meta-analyses have already highlighted the efficacy of in-person CBTs deployed during the perinatal period in reducing depression, anxiety, and stress symptoms [ 39 , 40 ]. However, the efficacy of digital CBTs seems only supported for a reduction in depression symptoms [ 41 , 42 ], since to date no review has been conducted to assess their efficacy in reducing anxiety or stress symptoms. On a similar note, the efficacy of digital CBTs in improving insomnia symptoms was reported for adults at large [ 43 ], yet there are no available reviews or meta-analyses focused on perinatal sleep issues.…”

“…A further evaluation of the available literature highlighted that studies investigating the efficacy of CBTs and third-generation CBTs have greatly focused on women in the postpartum period [ 47 , 48 ] or on the broader perinatal period (i.e., both ante- and postnatal) [ 49 ]. Moreover, these studies were based either on specific intervention protocols (e.g., traditional CBTs) [ 41 , 42 ] or conversely included psychological interventions at large [ 50 , 51 ], despite their specific theoretical background. In addition, among the studies that placed attention on pregnancy, the involved women presented either clinically relevant psychological symptoms or mental disorders, such as major depression [ 52 , 53 ], or were instead recruited from the general population regardless of their symptomatology level [ 41 , 42 , 54 ].…”

“…Moreover, these studies were based either on specific intervention protocols (e.g., traditional CBTs) [ 41 , 42 ] or conversely included psychological interventions at large [ 50 , 51 ], despite their specific theoretical background. In addition, among the studies that placed attention on pregnancy, the involved women presented either clinically relevant psychological symptoms or mental disorders, such as major depression [ 52 , 53 ], or were instead recruited from the general population regardless of their symptomatology level [ 41 , 42 , 54 ]. The only available study that solely included women with sub-clinical symptoms and no prior mental disorder considered the broader perinatal period and investigated the efficacy of in-person MBIs [ 46 ].…”