Effectiveness of Cognitive Behavioral Therapy for Post-partum Depression in Low and Middle-income Countries: A Systematic Review

Abstract

Background: Post-partum depression (PPD) is a prevalent psychological condition affecting 10-20% of women following childbirth, with higher rates in low and middle-income countries (LMICs) due to limited resources, poor access to mental health care, and sociocultural stressors. Cognitive Behavioral Therapy (CBT) is an evidence-based intervention for treating PPD in high-income countries, but its effectiveness in LMICs remains underexplored. Aim: This systematic review aims to synthesize evidence on CBT's effectiveness for post-partum women in LMICs, examine cultural and contextual factors, and provide recommendations for culturally-sensitive interventions. Methods: Following PRISMA Statement 2020 guidelines, a systematic search was conducted in electronic databases such as PubMed, PsycINFO, and Web of Science to identify studies evaluating CBT's effectiveness for post-partum women in LMICs. A narrative synthesis was used to analyze and synthesize findings, considering the heterogeneity in study designs, populations, and outcome measures. Results: The review included five studies, all of which reported a more significant decrease in Edinburgh Postnatal Depression Scale (EPDS) scores for the CBT intervention group compared to the control group. The studies varied in terms of populations, settings, and CBT delivery modes, with telephonic CBT, in-hospital CBT, and in-person CBT being utilized. Conclusion: The findings from this systematic review suggest that CBT may be effective in reducing depressive symptoms among post-partum women in LMICs. Further research is needed to strengthen the evidence base, refine intervention strategies, and develop more effective, accessible, and culturally-appropriate interventions for PPD in LMICs. Addressing these recommendations will contribute to better mental health outcomes for post-partum women and their families in developing countries.