Non-pharmacological interventions for perinatal depression and anxiety among adolescent mothers: A systematic review and meta-analysis

Background: Perinatal depression and anxiety are the most common mental health disorders among pregnant and postpartum adolescents. Pharmacological and non-pharmacological interventions exist for perinatal depression and anxiety; however, there is limited evidence on the effectiveness of non-pharmacological interventions in adolescent mothers. Aim: To identify, evaluate, and summarize the available evidence on the effectiveness of non-pharmacological interventions for the prevention and treatment of perinatal depression and anxiety in adolescent mothers. Methods: We followed the Cochrane guidelines in conducting the reviews and the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines in reporting the findings. Randomized clinical trials (RCTs), interventional studies, cohort studies, and case-control studies of non-pharmacological interventions that assessed depression and/or anxiety symptoms or diagnoses after intervention in adolescent mothers were eligible for inclusion. We searched PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO, as well as the reference lists of relevant studies and grey literature. Results: We identified eight clinical trials that were eligible for inclusion in the systematic review (n = 806); four of these studies were eligible for inclusion in a meta-analysis (n = 451). Non-pharmacological interventions (specifically Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT)) for depressive symptoms showed small to moderate effects (SMD: -0.57, 95 % CI: -0.77, -0.36; p-value<0.001) in the intervention groups compared to the control groups. Conclusions: Non-pharmacological interventions, specifically CBT and IPT, may be effective in treating perinatal depression among adolescent mothers. These interventions could be successfully delivered by trained health care professionals in health care settings such as antenatal clinics.