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Is collaborative care a key component for treating pregnant women with psychiatric and psychosocial symptoms?: A systematic review.
  • Celine Klatter,
  • Leontien van Ravesteyn,
  • Jelle Stekelenburg
Celine Klatter
University of Groningen

Corresponding Author:celine.klatter@mcl.nl

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Leontien van Ravesteyn
University of Groningen
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Jelle Stekelenburg
University of Groningen
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Abstract

Background: Mental disorders during pregnancy are common, with long-lasting negative effects on mother and child. The combination with psychosocial symptoms, barriers on population and healthcare level and lack of long-term evidence make treatment challenging. To overcome this, there is raising awareness for collaborative care. Objectives: Review perinatal mental health interventions and analyse the impact of collaborative care. Search strategy: Two independent reviewers searched for RCT’s in Pubmed, Embase and PsycINFO. Selection criteria: Trials studying the effect of psychological or pharmacological interventions on the mental health of pregnant women with psychiatric and/or psychosocial symptoms. Data collection and analysis: Two reviewers independently abstracted data and assessed study quality and risk of bias. Each study was scored on collaborative care criteria: multi-professional approach to patientcare, structured management plan, scheduled patient follow-ups, enhanced interprofessional communication. Main results: 35 studies were included. Most trials studied the effect of cognitive behavioural therapy and interpersonal psychotherapy on perinatal depression. Almost all interventions met at least one collaborative care criteria. Interventions were mostly provided by multiple professionals, but interprofessional communication rarely took place. Interventions that met more criteria did not more often show a positive effect on maternal mental health. Conclusions: There is lack of research on perinatal psychiatric disorders other than depressive and on long-term treatment outcomes. Collaborative care is partly implemented in most current interventions, but more trials (including interprofessional communication) are needed to be conclusive whether collaborative care is a key component in perinatal mental healthcare. Funding: None Keywords: pregnancy, mental disorders, psychosocial, collaborative care