Digital cognitive behavioural therapy (D.CBT) for pregnancy-related depression and sleep disturbances: a systematic review and meta-analysis

Abstract

Objective. Between 5% and 30% of women during the pregnancy and postpartum periods may suffer from depression. The management modalities are ranging from coping and support to medications and electroconvulsive therapy. Our study aimed to assess whether digital cognitive behavioural therapy (D.CBT) can improve pregnancy-related mood and sleep disorders. Materials and Methods. We combed four databases, Web of Science, PubMed, Scopus, and Cochrane Library. Randomized control trials comparing D.CBT with any control group for pregnancy-related depression and sleep disorders were selected for this study. Results. We included 14 studies based on the original data of 12 trials. D.CBT significantly decreased the Patient Health Questionnaire-9 (PHQ-9) after eight weeks compared to the control (MD =-2.77; 95%CI-4.01 to-1.53; p < 0.0001); however, no significant difference after four weeks of intervention or after six weeks of delivery. After eight weeks, D.CBT significantly decreased Inventory of Depression and Anxiety Symptoms (IDAS) (SMD =-0.48; 95%CI-0.78 to-0.18; p = 0.002), while after only four weeks, D.CBT was associated with higher IDAS than the control (SMD = 0.56; 95%CI 0.26 to 0.86; p = 0.0002). Also, D.CBT significantly decreased Generalized Anxiety Disorder Scale (GAD-7) (MD =-1.73; 95%CI-2.63 to-0.83; p = 0.0002), and Insomnia Severity Index (ISI) (MD =-3.45; 95%CI-5.66 to-1.24; p = 0.002) when compared to the control. Conclusions. D.CBT shows some promising outcomes in treating pregnant women’s depression and sleep difficulties as decreasing Patient Health Questionnaire-9 (PHQ-9), Depression and Anxiety Symptoms (IDAS), Generalized Anxiety Disorder Scale (GAD-7), and Insomnia Severity Index (ISI), especially after eight weeks of the intervention.