Efficacy of contextual therapies in perinatal depression and anxiety: A systematic review and meta-analysis

Anna Torres-Giménez*, Bàrbara Sureda, Alba Roca-Lecumberri, Susana Andrés-Perpiñá, Eva Solé, Estel Gelabert

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review


BACKGROUND: There are previous meta-analyses on the efficacy of cognitive behavioral therapy or mindfulness-based therapies in the perinatal period, but no previous review has focused on contextual therapies as a whole. The aim of this study was to carry out a systematic review and meta-analysis of the efficacy of contextual therapies on depressive and anxious symptoms in women in the perinatal period.

METHODS: A systematic search for randomized clinical trials has been carried out in the PUBMED, CINAHL, Psyc-INFO and Cochrane Library search engines. For the quantitative synthesis, the Morris effect size measure has been used.

RESULTS: A total of 34 RCTs have been found, of which 30 have been used for meta-analysis. The mean effect size of the studies on depression scores was d ppc2 = -0.81 (95% CI = -1.12 to -0.50), while it was d ppc2 = -1.04 (95% CI = -1.54 to -0.53) in the case of studies on anxiety scores. These effect sizes decreased to medium effect sizes when corrected for publication bias.

LIMITATIONS: The main limitations are the quality of the included studies, publication bias, and the limited number of studies on contextual therapies other than mindfulness-based therapies.

CONCLUSIONS: In conclusion, this systematic review found a large number of efficacy studies on mindfulness-based therapies and a small number of studies on the other contextual therapies. The effect sizes found are consistent with previous meta-analyses in the perinatal period.

Original languageEnglish
Pages (from-to)209-223
Number of pages15
JournalJournal of Psychiatric Research
Publication statusPublished - Jan 2024


  • ACT
  • Behavioral activation
  • Contextual therapy
  • MBI


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