Is the cognitive-behavioral therapy an effective intervention to prevent the postnatal depression? A critical review

Objective. The aim of this paper is to review and discuss the efficacy of the Cognitive-Behavioral Therapy (CBT), in the prevention of postnatal depression (PD) in pregnant women at risk. Method. PubMed, Medline, PsychInfo, Embase, and the Cochrane Library databases were searched from February 1991 to February 2011. Results. Eight Randomized Controlled Trials (RCT) on the prevention of PD with the CBT was selected and their data were analyzed. The literature analyzed recommends that depression in pregnancy requires an efficient management to provide mother's symptoms relief as well as to prevent the PD. While several studies demonstrated the efficacy of the CBT in the treatment of PD, the efficacy of the CBT in preventing PD in pregnant women at risk has been investigated only by a few studies, presenting a number of methodological flaws. Conclusions. Better designed RCT are needed to support the efficacy of such psychotherapeutic preventive strategy in women at risk for PD. Keywords: antenatal depression, cognitive-behavioral therapy, pregnancy, postnatal depression, prevention, post-rationalist cognitive approach.