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Non-Pharmacological Strategies for Postpartum Depression: A Network Meta-Analysis of Randomized Controlled Trials
Hilmi Amirul Haq1, Zainab Khalisah Nurulhaq1, Bryan Naufal Abdullah1
1Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia.
Iranian Journal of Psychiatry
|April 29, 2026
Summary
Therapy-Assisted Internet Cognitive Behavioral Therapy (TA-iCBT) is the most effective non-pharmacological treatment for postpartum depression (PPD). This finding offers a safe and beneficial alternative for mothers experiencing PPD.
Area of Science:
- Psychiatry
- Psychology
- Public Health
Background:
- Postpartum depression (PPD) significantly affects mothers, infants, and families.
- Pharmacological treatments for PPD in breastfeeding mothers can cause adverse effects.
- Non-pharmacological interventions are needed as safe alternatives for PPD management.
Purpose of the Study:
- To systematically review and synthesize evidence on non-pharmacological interventions for PPD.
- To conduct a network meta-analysis of randomized controlled trials (RCTs) evaluating PPD interventions.
- To identify the most effective non-pharmacological therapy for postpartum depression.
Main Methods:
- A systematic review and network meta-analysis of 13 RCTs from major databases (PubMed, Science Direct, Scopus, Cochrane Library).
- Network meta-analysis performed using RStudio with a random effects model.
- Risk of bias assessed using Rob 2.0, RoB-ME, and CINeMA.
Main Results:
- Therapy-Assisted Internet Cognitive Behavioral Therapy (TA-iCBT) demonstrated the highest benefit (MD = 6.90 [95% CI 5.35 to 8.45], p = 0.005).
- TA-iCBT showed the highest effectiveness (P-score = 0.891) with very low heterogeneity (I² = 0%).
- Other alternative therapies are safe but require patient-specific tailoring.
Conclusions:
- TA-iCBT is identified as the most effective non-pharmacological therapy for postpartum depression.
- TA-iCBT can be a primary choice for psychiatric treatment of PPD.
- Non-pharmacological approaches offer safe and effective management options for PPD.
