Prospective pre- and post-treatment and controlled studies that evaluated the impact of antidepressant medication or psychological interventions in women with unipolar depression (during pregnancy and a defined post-partum period of 12 months) were eligible for inclusion. Additional inclusion criteria were that outcomes were reported for depressive symptoms using validated self-report or clinician-administered measures and that the study provided sufficient data for calculation of effect sizes. Hormonal pharmacological interventions, non-specific psychosocial interventions and interventions that did not explicitly target depressive symptoms were excluded from the review.
The studies were conducted in UK, France, USA, Australia, Austria, Canada and Sweden. Interventions were generally administered at clinics or at home or a combination of both and were to individuals, groups or a combined format. One intervention was in a school setting. Psychotherapy interventions consisted of cognitive-behavioural therapy, interpersonal psychotherapy, non-directive counselling, psycho-dynamic therapy, psycho-educational group therapy and mother-infant therapy groups. Anti-depressant medications used were venlafaxine, sertraline, nefazodone and paroxetine. Omega-3 fatty acids were used alongside manualised supportive psychotherapy in one study. Control treatments were treatment as usual, wait list, active control and placebo treatments. Rating scales used for evaluation of depressive symptoms were Beck Depression Inventory, Edinburgh Post-Natal Depression Scale, Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale.
The authors did not state how many reviewers performed the study selection.