A Systematic Review of Integrated Care Interventions Addressing Perinatal Depression Care in Ambulatory Obstetric Care Settings

Abstract

This systematic review searched 4 databases (PubMed/MEDLINE, Scopus, CINAHL, and PsychINFO) and identified 21 articles eligible to evaluate the extent to which interventions that integrate depression care into outpatient obstetric practice are feasible, effective, acceptable, and sustainable. Despite limitations among the available studies including marked heterogeneity, there is evidence supporting feasibility, effectiveness, and acceptability. In general, this is an emerging field with promise that requires additional research. Critical to its real-world success will be consideration for practice workflow and logistics, and sustainability through novel reimbursement mechanisms.

Figure 1. Article Selection Process

Figure 2. Numbers and Percentages of Studies Containing Each Integrated Care Intervention Component

Figure 3. Outcome Results of the 21 Studies Included in the Systematic Review of Integrating Depression Care for Pregnant and Postpartum Adult Women in Obstetric Settings

For Sustainability as indicated by (*), representative examples are included. Abbreviations: BDI, Beck Depression Inventory; EPDS, Edinburgh Postnatal Depression Scale; DASS, Depression Anxiety Stress Scales; FTE, full-time equivalent; IPT, interpersonal psychotherapy; LCSW, licensed clinical social worker; MINI, Mini International Neuropsychiatric Interview; PHQ-9, Patient Health Questionnaire; ref, reference; SCID, Structured Clinical Interview for Diagnosis; SCL-20, Symptom Checklist Depression Scale