Revista multidisciplinaria
investigación Contemporánea ISSN-e: 2960-8015Vol. 3 -No. 207 - 2025
Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
365-394
Cognitive Behavioral Therapy
in the Treatment of Postpartum
Depression: A Systematic Review
Terapia Cognitivo Conductual en el Tratamiento
de la Depresión Postparto: Una Revisión Sistemática
Arévalo Colcha, Gabriela Elizabeth 1, Jaramillo Oyervide Jessica Alexandra 2,
Reivan Ortiz Geovanny Genaro 3
1 Catholic University of Cuenca; gabriela.arevalo.04@est.ucacue.edu.ec. Riobamba, Ecuador.
2 Catholic University of Cuenca; jajaramilloo@ucacue.edu.ec. Cuenca, Ecuador.
3 Catholic University of Cuenca; greivano@ucacue.edu.ec. Cuenca, Ecuador.
How to cite:
Gabriela Elizabeth, A. C., Jaramillo Oyervide, J. A., & Reivan Ortiz, G. G. (2025). Cognitive
Behavioral Therapy in the Treatment of Postpartum Depression: A Systematic Review. Revista
MultidisciplinariaInvestigación Contemporánea,, 3(2), 395–418. https://doi.org/10.58995/redlic.rmic.v3.n2.
a113
Article Information
Received: 19-02-2025
Accepted: 11-04-2025
Published: 01-07-2025
Editor’s Note
REDLIC remains neutral regarding jurisdictional
claims in published messages and institutional
afliations.
Editorial
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Contemporary Research (REDLIC)
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Funding Sources
The research was conducted using the authors’
own resources.
Conicts of Interest
No conicts of interest are declared.
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Revista multidisciplinaria
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DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Leucemia de células dendríticas plasmocitoides
- estudio y diagnóstico de un caso 49 -49
Copyright (c) 2025 Faicán Rocano Pedro Fernando, Dután Pérez Ibelice Salomé,
González González Camila Raquel, Matute Aguiar Joselyn Nayeli, Rodríguez Ver-
dugo Alejandra Valentina.
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Review article. Revista MultidisciplinariaInvestigación Contemporánea.
Vol. 3 - No. 2, pp. 365 - 394. July-December, 2025. e-ISSN: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
Revista multidisciplinaria
Investigación Contemporánea 07 - 2025 Vol. 3 - No. 2 ISSN-e: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Leucemia de células dendríticas plasmocitoides
- estudio y diagnóstico de un caso 32 -49
Artículo Caso clínico. Revista multidisciplinaria investigación Contemporánea.
Vol. 3 - No. 2, pp. 32 - 49. julio-diciembre, 2025. e-ISSN: 2960-8015
Leucemia de células dendríticas
plasmocitoides - estudio y diagnóstico
de un caso
Leucemia de células dendríticas plasmocitoides - estudio y
diagnóstico de un caso
Información del artículo:
Recibido: 05-12-2024
Aceptado: 21-02-2025
Publicado: 01-07-2025
Nota del editor:
REDLIC se mantiene neutral con respecto a
reclamos jurisdiccionales en mensajes publi-
cados y aliaciones institucionales.
Editorial:
Red Editorial Latinoamericana de Investigación
Contemporánea (REDLIC) www.editorialredlic.com
Fuentes de nanciamiento:
La investigación fue realizada con recursos propios.
Conictos de interés:
No presentan conicto de intereses.
Este texto está protegido por una licencia Creative Commons 4.0.
Usted es libre para Compartir —copiar y redistribuir el material en cual-
quier medio o formato— y Adaptar el documento —remezclar, transformar
y crear a partir del material— para cualquier propósito, incluso para nes
comerciales, siempre que cumpla la condición de:
Atribución: Usted debe dar crédito a la obra original de manera adecuada,
proporcionar un enlace a la licencia, e indicar si se han realizado cambios.
Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugie-
ra que tiene el apoyo del licenciante o lo recibe por el uso que hace de la obra
1 Docente Investigador; pedro.faican@ucacue.edu.ec. Azogues, Ecuador.
2 Estudiante; ibelice.dutan.44@est.ucacue.edu.ec. Azogues, Ecuador.
3 Estudiante; camila.gonzalez.66@est.ucacue.edu.ec. Azogues, Ecuador.
4 Estudiante; joselyn.matute.44@est.ucacue.edu.ec. Azogues, Ecuador.
5 Estudiante; alejandra.rodriguez.60@est.ucacue.edu.ec. Azogues, Ecuador.
Faicán Rocano Pedro Fernando 1, Dután Pérez Ibelice Salomé 2, González González Camila
Raquel 3, Matute Aguiar Joselyn Nayeli 4, Rodríguez Verdugo Alejandra Valentina 5
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Cómo citar:
Faican Rocano, P. . F., Dután Pérez, I. S. ., González González, C. R. ., Rodríguez Verdugo, A. V. ., & Matute Aguiar, J.
N. . (2025). Leucemia de células dendríticas plasmocitoides - estudio y diagnóstico de un caso.
Revista Multidisci-
plinaria Investigación Contemporánea
, 3(2), 32-49. https://doi.org/10.58995/redlic.rmic.v3.n2.a90
Revista multidisciplinaria
Investigación Contemporánea 07 - 2025 Vol. 3 - No. 2 ISSN-e: 2960-8015
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
Inteligencia Emocional y Uso de Redes Sociales en Adolescentes 395 - 418
Artículo original. Revista multidisciplinaria investigación Contemporánea.
Vol. 3 - No. 2, pp. 395 - 418. julio-diciembre, 2025. e-ISSN: 2960-8015
Inteligencia Emocional y Uso de Redes
Sociales en Adolescentes
Emotional Intelligence and Social Media Use in Adolescents
Información del artículo:
Recibido: 19-02-2025
Aceptado: 11-04-2025
Publicado: 01-07-2025
Nota del editor:
REDLIC se mantiene neutral con respecto a
reclamos jurisdiccionales en mensajes publi-
cados y aliaciones institucionales.
Editorial:
Red Editorial Latinoamericana de Investigación
Contemporánea (REDLIC) www.editorialredlic.com
Fuentes de nanciamiento:
La investigación fue realizada con recursos propios.
Conictos de interés:
No presentan conicto de intereses.
Este texto está protegido por una licencia Creative Commons 4.0.
Usted es libre para Compartir —copiar y redistribuir el material en cual-
quier medio o formato— y Adaptar el documento —remezclar, transformar
y crear a partir del material— para cualquier propósito, incluso para nes
comerciales, siempre que cumpla la condición de:
Atribución: Usted debe dar crédito a la obra original de manera adecuada,
proporcionar un enlace a la licencia, e indicar si se han realizado cambios.
Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugie-
ra que tiene el apoyo del licenciante o lo recibe por el uso que hace de la obra
1 Universidad Nacional de Chimborazo; jhon_ajag@hotmail.com. Quito, Ecuador.
2 Universidad Nacional de Chimborazo; asarmiento@unach.edu. Quito, Ecuador.
Juan Andrés Granda Brito 1*, Alejandra Salome Sarmiento Benavides 2,
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
Cómo citar:
Gabriela Elizabeth, A. C., Jaramillo Oyervide , J. A., & Reivan Ortiz , G. G. (2025). Terapia Cognitivo Conductual
en el Tratamiento de la Depresión Postparto: Una Revisión Sistemática. Revista Multidisciplinaria Investigación
Contemporánea, 3(2) 395-418. https://doi.org/10.58995/redlic.rmic.v3.n2.a113
Revista multidisciplinaria
investigación Contemporánea ISSN-e: 2960-8015Vol. 3 -No. 207 - 2025
Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
366-394
Abstract
Postpartum depression (PPD) is a psychological condition that occurs in
women during and after childbirth, characterized by symptoms of sadness, anxiety,
and difculties adequately caring for their baby. Studies suggest that cognitive-
behavioral therapy (CBT) is most effective if it focuses on changing one’s own
thoughts. The following provides an explanation of the effectiveness of CBT in the
treatment of postpartum depression through a systematic review. This is the main
objective of the article. Searches were conducted in the Web of Science, Scopus,
and PubMed databases, considering studies published between 2019 and 2024.
The PRISMA and CONSORT methodology was applied to assess the quality of the
selected studies. As a result, 17 articles were analyzed, most of which concluded that
cognitive-behavioral therapy is effective in reducing the symptoms of postpartum
depression. It is concluded that this therapy, in its various modalities, promotes
maternal adaptation and improves the mother-child relationship, making it
necessary to adapt its application to the context and individual needs of each
mother.
Keywords: Cognitive-behavioral therapy, efcacy, postpartum depression,
systematic review.
Resumen
La depresión posparto es una afección psicológica que se presenta en las
mujeres durante y después del parto, caracterizado por síntomas de tristeza,
ansiedad y dicultades para cuidar adecuadamente del bebé. Estudios sugieren
que la terapia cognitivo-conductual (TCC) es más efectiva si se centra en cambiar
los propios pensamientos. A continuación se proporciona una explicación de
la ecacia de la TCC en el tratamiento de la depresión posparto a través de una
revisión sistemática. Siendo este el principal objetivo del artículo. Se realizaron
búsquedas en las bases de datos Web of Science, Scopus y PubMed, considerando
estudios publicados entre 2019 y 2024. Se aplicó la metodología PRISMA y
CONSORT para evaluar la calidad de los estudios seleccionados. Como resultado,
se analizaron 17 artículos que en su mayoría concluyen que la terapia cognitivo-
conductual es efectiva en la reducción de los síntomas de la depresión posparto.
Se concluye que esta terapia, en sus diversas modalidades, favorece la adaptación
materna y mejora la relación madre-hijo, siendo necesario adaptar su aplicación
al contexto y necesidades individuales de cada madre.
Palabras clave: Terapia cognitivo-conductual, ecacia, depresión postparto,
revisión sistemática.
Revista multidisciplinaria
investigación Contemporánea ISSN-e: 2960-8015Vol. 3 -No. 207 - 2025
Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
367-394
1. Introduction
Postpartum depression (PPD) has been identied as a psychological
disorder that affects women after childbirth, characterized by symptoms
such as sadness, anxiety, irrational fears, and difculties in caring for
newborns (Molina et al., 2021). This disorder interferes with the mother’s
emotional well-being and her relationship with her child (Alverenga et
al., 2018). Factors such as a history of depression, depressive symptoms
during pregnancy, and lack of social support have been identied as main
triggers (González et al., 2019). The World Health Organization recognizes
it as a public health problem with a prevalence of 10% to 20% in Latin
America ( Alverenga et al., 2018).
Globally, recent studies have estimated that between 15% and
23% of women experience PPD symptoms, with a higher prevalence
among younger women, those with a family history of depression, or
those who have experienced violence (Acuña et al., 2021; Villegas et al.,
2019). Furthermore, prevalence rates vary according to cultural factors,
emphasizing the need for contextually tailored treatment strategies (Van
Lieshout et al., 2023).
cognitive behavioral therapy (CBT) has been widely studied
as an effective treatment for postpartum depression. This approach,
developed by Beck, is based on the development of cognitive theory and
the understanding of the connections between thoughts, feelings, and
behaviors ( Alimoari et al., 2022 ; Li et al., 2022 ). Recent research has
demonstrated its effectiveness in cognitive restructuring, behavioral
activation, and problem-solving skills training, which are essential for
reducing depression ( Milgrom et al., 2021 ). Similarly, CBT has been
shown to be benecial in improving maternal resilience and promoting
mother-child bonding, which is essential for maternal and child health (
Monaco, 2019 ).
Revista multidisciplinaria
investigación Contemporánea ISSN-e: 2960-8015Vol. 3 -No. 207 - 2025
Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
368-394
The transition to motherhood is a critical period in which women
experience challenges related to their personality, relationships, and
psychological and physical changes (Li et al., 2022), and for this reason, it
can represent a time of increased risk for women to develop mental health
problems ( Alimoari et al., 2022 ) . Postpartum depression (PPD) is the
most common psychological disorder after childbirth, with a prevalence
of 20% (González et al., 2019; Milgrom et al., 2021). Postpartum depression
is dened as an episode of depression that occurs from birth to 12 months
(WHO, 2018) and causes negative consequences for the mother, the child,
and the mother-child relationship (Bahar et al., 2021; Monaco , 2019).
Psychological interventions are effective in treating postpartum
depression (Duffecy et al., 2019) and are among the options for postpartum
women. A recent review of systematic reviews and in-depth analyses
showed that cognitive behavioral therapy (CBT) is the most effective way to
support postpartum depression. According to the type of CBT, awareness
is the “key” to a person’s feelings and behavior in certain situations (Darcy
et al., 2023; Franco et al., 2020). CBT-based interventions for PPD are
based on this principle, which also assumes that previous experiences and
factors (e.g., biological and psychological) contribute to the development
of vulnerability to certain underlying beliefs ( Duffecy et al., 2019) .
Wenzel and Kleiman (2015) also hypothesized that these beliefs,
which manifest solely through negative thoughts, are activated during
periods of stress that lead to change or adaptation and therefore play
an important role in the development and maintenance of postpartum
depression. Given the complexities of childbirth, CBT treatment in
this context must focus on specic beliefs about women and integrate
them with society in order to function effectively (Husain et al., 2023),
covering aspects such as the need for practical and emotional support
and addressing changes in the couple’s relationship (Liu and Yang, 2020).
Of the many effective treatments, many women do not seek professional
help for their postpartum symptoms (Fonseca et al., 2015) due to lack of
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information (e.g., where to nd help) and practical barriers (e.g., lack of
time and childcare limitations), as well as perceived stigma (Button et al.,
2000; Goodman). Recently, efforts have been made to develop new ways to
support mental health, such as peer support.
Despite the existence of effective treatments, many women do
not seek professional help for their postpartum depressive symptoms
(Fonseca et al., 2015 ) due to lack of knowledge (e.g., where to get help) and
practical barriers (e.g., lack of time and childcare limitations), as well as
perceived stigma (Button et al., 2017; Goodman, 2009). Recently, efforts
have been made to develop new formats of psychological interventions,
such as combination interventions.
Blended interventions combine traditional in-person psychotherapy
with e-mental health tools, such as web-based programs, that build upon
each other in a sequential and integrated protocol (Erbe et al., 2017 ). In
this format, sessions via online programs can replace some in-person
sessions with a therapist. It is common to incorporate time-consuming
psychotherapy elements, such as psychoeducation and exercises, into
web-based programs to provide patients with an opportunity to practice
between sessions and integrate strategies into daily routines (Ebert et al.,
2018).
Therefore, a combination treatment for PPD could present many
advantages for postpartum women, such as reduced costs (fewer sessions
with a therapist, reduced travel costs) and greater exibility, accessibility,
and intensity by narrowing the time gap between in-person sessions.
Furthermore, a combination treatment also contributes to increasing
women’s autonomy by allowing them to progress in their own time and
at their own pace, access content and exercises between sessions with
a psychologist (Titzler et al ., 2018), and reduce the shame and stigma
associated with seeking help.
Despite advances in the understanding and use of CBT for
postpartum depression, challenges remain, including variability in
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Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
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individual response, limited availability of mental health services, and
the stigma associated with seeking treatment. A need for further research
has been identied to evaluate its long-term efcacy and compare it with
other treatment options ( Bahar et al., 2021).
In this article, this study aims to describe the effectiveness of CBT
in the treatment of PPD through a randomized controlled trial. To do so,
studies published between 2019 and 2024 were reviewed, using statistical
tools such as CONSORT to assess the quality of evidence. The results
obtained will provide a better understanding of the effects of CBT in
this vulnerable population, which will contribute to the optimization of
treatment strategies and the improvement of interventions and access.
2. Methodology
The systematic review was conducted according to the PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
owchart, which ensures transparency and rigor in the selection of
included studies. The purpose of this data analysis was to obtain valid and
reliable conclusions regarding the effectiveness of Cognitive-Behavioral
Therapy in reducing symptoms of Postpartum Depression. By following
a rigorous and systematic approach to data analysis, the quality and
reliability of the conclusions obtained in the systematic review were
guaranteed (Donis, 2013).
Eligibility criteria:
The established criteria were designed to ensure the inclusion of
studies that met quality standards and thematic relevance on the efcacy
of CBT in the treatment of PPD.
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Inclusion:
• Studies published during the last 5 years.
• Studies in which a psychological intervention with CBT has
been carried out for PPD.
• Studies detailing the effectiveness of cognitive behavioral
treatments in mothers with PPD.
• Studies are freely accessible and available for download in their
full versions.
• Documents in Spanish and English from indexed journals that
use the peer-review method.
• Articles with quartile from 1 to 4.
• Include quantitative studies associated with randomized and
longitudinal clinical trials in order to have greater resources
for analysis.
Exclusion
• Studies containing duplicate records.
• Studies with unclear methodology regarding the synthesis of
information on the effectiveness of CBT for PPD.
• Studies that, as part of your treatment, include only
pharmacological and non-therapeutic aspects.
• Different sample than adult mothers with PPD or who did not
receive treatment.
• Studies that contain another type or approach to
psychotherapeutic treatment.
Information sources and search strategies
The information search was conducted on October 31, 2022, and two
additional searches were subsequently conducted on May 16, 2023, and
July 18, 2024, to obtain more articles that met the information required for
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this work. Databases such as Web of Science, Scopus, and PubMed were
reviewed, including terms associated with PPD as well as contemporary
psychological treatments (CBT), using Boolean operators that resulted in
the following search string: (“Cognitive Behavior Therapy” OR “Cognitive
Behavioral Therapy”) AND (“Postpartum Depression” OR “Postnatal
Depression” OR “Puerperal Depression”). After identifying the articles,
each one was evaluated according to the aforementioned inclusion
criteria, taking into account the titles, abstracts, and keywords.
Study selection and data extraction processes
In the context of the prior data analysis, which involved collecting
and organizing data extracted from studies included in the review using
Rayan software, relevant data were compiled from the studies selected for
selection. These included study characteristics based on sample, study
type, and design, in addition to extracting the results and main clinical
ndings on the efcacy of CBT for PPD. Additionally, it involved extracting
numerical data, such as outcome measures, as well as qualitative data with
descriptions of interventions and study contexts.
In this case, duplicates were eliminated and titles and abstracts were
screened according to inclusion and exclusion criteria to obtain crucial
information . The collected data were then systematically organized using
tools such as PRISMA graphs and summary tables to facilitate visualization
and understanding. This organization was crucial for identifying patterns
of improvement in depressive symptoms, trends in the efcacy of CBT
over time, and discrepancies in results between studies that used different
intervention methods (face-to-face, online, or blended).
Publication bias assessment
To analyze the methodological quality of the studies, the
Consolidated Standards of Reporting Trials (CONSORT) tool was used. It
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investigación Contemporánea ISSN-e: 2960-8015Vol. 3 -No. 207 - 2025
Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
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DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
Terapia Cognitivo Conductual en el Tratamiento de la Depresión
Postparto: Una Revisión Sistemática 373 - 394
Evaluación de sesgo de la publicación
Para analizar la calidad metodológica de los estudios, se realizó el análisis
mediante la herramienta CONSORT (Consolidated Standards of Reporting
Trials). Particularmente se utilizó para evaluar la calidad metodológica de
ensayos clínicos aleatorizados, mediante criterios como aleatorización, im-
plementación, análisis de resultados, entre otros. Al estandarizar la presenta-
ción de los datos, se busca minimizar sesgos, promover la comparabilidad en-
tre investigaciones y reforzar la conanza en los hallazgos cientícos (Schulz,
2010). La lista de vericación CONSORT se empleó de manera individual a los
artículos, calicándolos según su rigor metodológico: (+) para cumplimiento
completo, (P) para cumplimiento parcial, y una calicación en blanco en caso
de ausencia de cumplimiento. Este sistema de puntuación detallado facilitó
una evaluación minuciosa de la calidad de los ensayos, brindando una medi-
da estandarizada y objetiva de calidad metodológica.
Método de síntesis
A lo largo del proceso se usó PRISMA que cuenta con etapas clave: identica-
ción inicial de estudios en bases de datos, eliminación de duplicados, cribado
por títulos y resúmenes según los criterios de inclusión, y evaluación a texto
completo de los estudios potencialmente elegibles.
Otro método de síntesis fue la construcción de tablas para registrar la
extracción de información válida que justique el objetivo de estudio. Este
enfoque refuerza la calidad y transparencia del proceso de selección, asegu-
rando que los estudios evaluados cumplieran con los estándares metodológi-
cos establecidos para la revisión sistemática.
was specically used to assess the methodological quality of randomized
clinical trials, using criteria such as randomization, implementation,
and results analysis, among others. By standardizing data presentation,
the aim is to minimize bias, promote comparability between studies, and
reinforce condence in scientic ndings (Schulz, 2010). The CONSORT
checklist was applied to individual articles, scoring them according to
their methodological rigor: (+) for complete compliance, (P) for partial
compliance, and a blank score for non-compliance. This detailed scoring
system facilitated a thorough assessment of trial quality, providing a
standardized and objective measure of methodological quality.
Synthesis method
Throughout the process, PRISMA was used, which has key stages:
initial identication of studies in databases, elimination of duplicates,
screening by titles and abstracts according to inclusion criteria, and full-
text evaluation of potentially eligible studies.
Another synthesis method was the construction of tables to record
the extraction of valid information that justies the study objective. This
approach reinforces the quality and transparency of the selection process,
ensuring that the evaluated studies met the methodological standards
established for systematic reviews.
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Cognitive Behavioral Therapy in the Treatment of Postpartum Depression:
A Systematic Review
DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
374-394
Figure 1. Flowchart of the systematic review process. Source: Arévalo,
Gabriela (2025).
As a result of the search in Scopus , Web of Science and PubMed,
1244 articles were identied. After following the exclusion criteria, 141
duplicate articles and 769 additional articles were removed due to lack
of relevance. Subsequently, 25 studies that focused on non-psychological
treatments, such as medication, or that did not clearly demonstrate the
efcacy of cognitive-behavioral therapy (CBT) were discarded. Ninety-
eight studies were excluded because their numbers or samples did not
meet the selection criteria. Additionally, 114 articles were excluded
for addressing irrelevant issues and 68 for focusing on psychological
treatments and approaches other than CBT. Finally, 12 studies that did
not demonstrate drug use were discarded. Following this selection, 17
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studies that met the criteria were included, primarily those examining
CBT approaches for postpartum depression (PPD).
3. Development
Effectiveness of CBT in Postpartum Depression
The Effectiveness of CBT for Postpartum Depression The reviewed
studies have shown that cognitive behavioral therapy (CBT), in its
various modalities (individual, group, and online), signicantly reduces
depressive symptoms in women with postpartum depression (PPD).
Delivery methods via mobile apps were also effective for women who
needed greater exibility in their medication regimens, suggesting that
hybrid and web-based methods are useful for this population.
Individual and group intervention
Liu and Yang (2021) showed that after six weeks of cognitive
intervention, women who received this treatment for the rst time showed
a signicant reduction in symptoms of depression and anxiety compared
to the control group. Furthermore, it was shown that CBT can prevent
the development of PPD and increase satisfaction with the care received.
Van Liesout et al., (2022) reported that mothers who participated in
groups used CBT methods in the management of their children, achieving
relevant changes in depression, childhood anxiety, rejection and anger,
with stable results up to six months after treatment.
Van Lieshout et al. (2023) found that one-day face-to-face CBT
sessions were effective in treating postpartum depression, with signicant
improvements in depression, anxiety, and mother-infant bonding. They
also had a positive effect on the behavior of infants under 12 months of
age, although the same effect was not observed in older children.
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As for Jidong et al. (2024) they showed that culturally adapted CBT
for British African or Caribbean women improved treatment satisfaction,
retention and engagement, signicantly reduced postpartum depression
and anxiety and strengthened support networks. Simhi et al. (2021)
reviewed the effectiveness of a CBT-based workbook and concluded that
both group and individual aspects were effective in reducing anxiety,
depression and stress in postpartum women, although the individual
aspects showed a fundamental improvement .
Similarly, Duffecy et al. (2022) examined the Sunnyside online
intervention to prevent PPD in pregnant women with mild to moderate
ED, and found improvement in symptoms over time with no signicant
differences between groups or means.
Technology-based interventions
Milgrom et al. (2021) found that online CBT was as effective as
in-person CBT in relieving depression after 21 weeks, but showed a
signicant reduction in symptoms over time. At follow-up, symptoms of
depression, anxiety, and depression were reduced by 50%. Qin et al. (2022)
using a mobile app-based CBT program provided preliminary evidence
of reduced depressive symptoms in postpartum mothers, although no
relevant improvements in anxiety were observed during a very early four-
week period.
Van Lieshout et al. (2021) showed that one-day CBT-based online
workshops are effective in reducing symptoms of postpartum depression
and anxiety, while also improving mother-infant social support and
bonding, as well as positive affectivity in infants regardless of the type of
therapist. Darcy et al. (2023) showed that Woebot, a digital therapeutic
agent based on CBT principles, is effective in treating postpartum
depression, with signicant improvements in depression and anxiety
scores compared to a control group, while participants reported high
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satisfaction with the device and good acceptance of the digital therapeutic
bond comparable to that of human therapists.
In the study Duffecy et al. (2019) analyzed how the internet helped
prevent PPD and found that only 5% of at-risk women developed
PPD, compared to 17% in the no-intervention group. Furthermore, the
intervention reduced depression in many participants and its use was
higher than other online programs . Research by Carona et al. (2023) found
that the “Web Be a Mom ” intervention was highly effective in reducing
symptoms of depression and anxiety in postpartum women at high risk
for depression, with positive effects being especially notable in those
participants with severe symptoms of depression at baseline. Meanwhile,
Monteiro et al. (2024) reviewed “Be a Mother ” and found that the
intervention beneted women with severe symptoms and demonstrated
a stable cost-effectiveness ratio, although the nal score was lower in the
intervention group compared to the control group.
Comparisons and limitations
According to Suchan et al. (2022) compared structured therapy with
a therapist-assisted CBT program in new mothers and found that the
majority of participants in the intervention group had reduced anxiety,
depression, and depression for up to six months. However, after the rst
month, signicant differences were only seen in anxiety. In contrast, Seo
et al. (2022) found that in mothers with PPD the CBT-based app had no
signicant impact on reducing depressive symptoms after eight weeks
of use, although there were no substantial improvements in knowledge
about depression, maladaptive beliefs, stress coping, social support, or
sleep quality, a signicant increase was observed in health-promoting
behaviors such as daily enjoyable activities.
Finally, Husain et al. (2023) found no differences in depression levels
between mothers who received a CBT group intervention and the control
group at the three- and six-month follow-ups. However, the retention rate
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Revista multidisciplinaria
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DOI: https://doi.org/10.58995/redlic.rmic.v3.n2.a113
Terapia Cognitivo Conductual en el Tratamiento de la Depresión
Postparto: Una Revisión Sistemática 378 - 394
Finalmente, Husain et al. (2023) no encontraron diferencias en los nive-
les de depresión entre las madres que recibieron una intervención grupal en
TCC y el grupo de control en los seguimientos a tres y seis meses. Sin embar-
go, la tasa de retención fue alta (76 %) y las participantes reportaron mejoras
en su actitud y conanza, con una mayor reducción en los síntomas depresi-
vos en aquellas que asistieron a más sesiones.
Tabla 1
Cuadro de autores analizados
Características del Estudio Tratamiento Resultados
N Estudio País Tamaño Edad
media Diseño
Herra-
mientas
de eva-
luación
Diagnósti-
cos/ estado
clínico
Tipo de
aplicación Dispositivo Sesiones Ecacia
1
Duffecy
et al.
(2019)
Estados
Unidos 25 30,5
años ECA
HDRS
IDAS-
NPHQ
Síntomas
DPP
TCC
basada en
Internet
Individual y
Grupal
8 semanas
x 10 a 15
minutos
La reducción de
los síntomas de
depresión fue
positiva, donde el
apoyo de los pares
fue útil para man-
tener la adheren-
cia al tratamiento.
2
Liu y
Yang
(2021)
China 260
26,89
y 27,31
años
ECA
HAMD
HAMA
EPDS
PSQI
DPP TCC pre-
sencial Individual
Una vez
por semana
durante 6
semanas x
1 hora cada
sesión
Redujo la inciden-
cia de depresión
posparto con el
alivio de la ansie-
dad y la depresión.
3
Van Lies-
hout et al.
(2021)
Canadá 403 31,8
años ECA
EPDS
GAD-7
PBQ
Síntomas
DPP
Talleres
en línea
basado en
TCC
Grupal
Cuatro
módulos en
un día x 7
horas
Presentó mejoras
signicativas en
la depresión pos-
parto, ansiedad,
apoyo social, afec-
tividad positiva de
los bebés y vínculo
madre-hijo.
was high (76%), and participants reported improvements in their attitude
and condence, with a greater reduction in depressive symptoms in those
who attended more sessions.
Table 1
Table of authors analyzed
N
Study Country
Study Features Treatment Results
Size Middle
Ages Design Assessment tools Diagnoses/
clinical status
Application
type Device Sessions Effectiveness
1
Duffecy
et al.
(2019)
USA 25 30.5
years ECA HDRS
IDASPHQ
PPD
Symptoms
Internet-based
CBT
Individual
and Group
8 weeks
x 10 to 15
minutes
The reduction in
depression symptoms
was positive, with
peer support helpful
in maintaining
treatment adherence.
2
Liu and
Yang
(2021)
China 260
26.89
and
27.31
years
ECA
HAMD
HAMA
EPDS
PSQI
DPP In-person CBT Individual
Once a week
for 6 weeks x
1 hour each
session
Reduced the
incidence of
postpartum
depression by
alleviating anxiety
and depression.
3
Van
Lieshout
et al.
(2021)
Canada 403 31.8
years ECA
EPDS
GAD-7
PBQ
PPD
Symptoms
Online
workshops
based on CBT
Group
Four
modules in
one day x 7
hours
Signicant
improvements
were reported
in postpartum
depression, anxiety,
social support,
positive infant
affectivity, and
mother-child
bonding.
4Simhi et
al. (2021) Israel 34 30.79
years
Single-
group
open
trial
EPDS
GAD
DASS
PPD
Symptoms
WAWA Protocol
based on TCC
Individual
by phone
and Group
Once a
week x four
weeks.
Both intervention
formats signicantly
reduced depression,
anxiety, and stress.
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5
Milgrom
et al.
(2021)
Australia 116 30.8
years ECA BDI-II
PHQ-9 DASS-21
DPP
Online CBT +
coaching calls Individual
One session
each week x
6 sessions
Reduced the severity
of depression
symptoms and
perceived stress.
6Qin et al.
(2022) China 112
31.6 and
32.2
years
ECA
GAD-7
EPDS
PPD
Symptoms
App-based CBT
CareMom Individual
28 daily
challenges
for 4 weeks
x 2 to 4
minutes
Depression decreased
signicantly, which
did not occur in the
control group.
7
Suchan
et al.
(2022)
USA 63 30.83
years
Pilot
study
EPDS
GAD-7
PHQ-9
DPP Transdiagnostic
CBT online Individual 5 lessons x 8
weeks
There were
signicant
improvements in
depression, anxiety
and general distress.
8
Van
Lieshout
et al.
(2022)
Canada 234
31.4 and
30.4
years
ECA EPDS DPP TCC Group
9 weekly
sessions x 2
hours
It reduced worry,
anxiety, anger,
and rejection,
and improved the
mother-child bond,
with stable effects at
six months.
9
Duffecy
et al.
(2022)
USA 208 29.08
years ECA PHQ
HAMDIDASMINI
PPD
Symptoms
Internet-based
CBT
Individual
and Group
8 weeks
x 10 to 15
minutes
The individual and
group programs did
not have signicant
differences in the
results, and both
showed a decrease
in anxiety and
depression.
10 Seo et al.
(2022) Korea 73
33.54
and
33.36
years
ECA EPDS DPP Mobile app-
based TCC Individual
Free access
for eight
weeks
There was no
difference in the
intervention effect
on postpartum
depression, but there
was improvement
in maternal health
behaviors.
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11
Van
Lieshout
et al.
(2023)
Canada 461
31.6 and
32.3
years
ECA
EPDS
GAD-7
PBQ
PPD
Symptoms
In-person
workshops
based on CBT
Group 4 workshops
x 7 hours
Decreased
depression, anxiety,
rejection, anger,
and baby-centered
anxiety, increased
mother-baby
bonding, and
increased children’s
effortful control.
12 Husain et
al. (2023)
United
Kingdom 83
30.4
and 30.1
years
ECA
EPDS
PHQ-9
DPP Culturally
adapted CBT
Group
12 sessions
of 90
minutes
each, once a
week, for 3
months.
There was no
signicant difference
in the reduction
of depression,
but awareness of
mental health issues
improved.
13 Carona et
al. (2023) Portugal 1053
32.81
and
32.91
years
ECA EPDS
PDPI-R
PPD
Symptoms
Internet-based
CBT Individual
5 modules
in 8 weeks x
45 minutes
Since the beginning
of treatment,
depression and
anxiety were shown
to be reduced.
14 Darcy et
al. (2023) USA 192 Nd ECA
PHQ-9
GAD-7
PPD
Symptoms
Agent-Guided
CBT WB001 Individual Daily use
for 8 weeks
x 5 to 10
minutes
It was shown to
signicantly reduce
depression and
anxiety.
15 Franco et
al. (2024) Chili 65 32.53
years ECA PHQ-9
EPDS
PPD
Symptoms Web-based TCC
Individual 6 modules x
8 weeks
It helped to modify
negative thoughts
and dysfunctional
beliefs about
parenting and
caregiving.
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16 Jidong et
al. (2024)
United
Kingdom 130 Nd ECA PHQ-9 DPP
Culturally
adapted CBT
LTP+CaCBT
Group
12 sessions
of 60
minutes x
once a week.
It has been shown to
reduce depression,
parenting concerns,
and increase positive
moods.
17
Monteiro
et al.
(2024)
Portugal 1052
32.91
and
32.81
years
ECA PDPI-R DPP Internet-based
TCCi Individual For 14
months
It had health effects
and lower costs, and
could help manage
DPP symptoms
effectively.
Discussion
Research suggests that the use of cognitive behavioral therapy
(CBT) in the treatment of postpartum depression (PPD) is effective and
leads to good outcomes (Milgrom et al., 2021; Qin et al., 2022; Darcy et al.,
2023; Franco et al., 2024; Monteiro et al., 2024; Daffesi et al., 2022). Overall,
interventions using CBT techniques reduce depressive and anxiety
symptoms and promote healthy habits and behaviors by developing
exibility and adaptability in patients.
According to the reviewed studies, various CBT-based
psychotherapies were demonstrated, with varying durations and types
of treatment, ranging from 4 to 6 weeks of interventions to in-person
individual therapy. They were effective and long-lasting. The group
signicantly reduced obsessive thoughts, irrational fears, sadness, and
other symptoms, and improved relationships with children, in addition
to improving the proper management of emotions (Liu & Yang, 2021;
Van Lieshout et al., 2022; Husain et al., 2023) . The authors demonstrated
that CBT is an excellent treatment for signicantly alleviating the
aforementioned symptoms of postpartum depression.
Regarding the intervention modality, Seo et al. (2022) and Duffecy
et al. (2019) conducted individual and group interventions in the United
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States and South Korea, respectively, demonstrating the importance of
cultural context in different groups. This process makes the treatment
efcacy inconclusive, since in South Korea, lasting and evident
improvements were achieved through individual therapy, while similar
efcacy was achieved in the United States. However, there is no doubt that
the tools used are effective in a high percentage of different cultures and
lead to symptom relief and signicant benets.
On the other hand, among the various intervention methods
currently available, intensive, short-term, and guided interventions
have achieved good results because they focus on specic symptoms
(Van Lieshout et al., 2021, 2023; Darcy et al., 2023). In addition, there are
online intervention methods such as those by Duffecey et al. (2019) and
Carona et al. (2023), who highlighted that only about 5% of interventions
developed PPD. The prevention effect was 95%, but the efcacy rate was
higher in women with severe symptoms, and at the same time, the dropout
rate was high. They have been shown to be a useful tool for alleviating
symptoms of postpartum depression and increasing patient acceptance
and participation due to the low need for skilled workers, short-term
intervention, and affordable cost and availability of therapists.
Regarding risk factors for the effectiveness of CBT-based therapy,
it was observed that situations such as single mothers, rst-time
mothers, and a lack of healthy behavioral habits before pregnancy were
predisposing factors for the development of PPD with acute symptoms.
These patients beneted from treatment in different ways. Some patients
achieved 100% results for at least six months, while others only noticed
signicant differences in attitude and condence. However, it is important
to note that there were positive benets on several levels.
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4. Conclusions
CBT is proven to be effective on electronic devices due to its ease of
access, especially for this population whose medical condition makes it
difcult to access in-person psychotherapeutic treatment. Regarding the
type of device, it is evident that at the individual level, better results were
obtained in terms of sustained symptom reduction over the medium term.
It is concluded that this is due to the possibility of developing interventions
focused on personality characteristics and functional dynamics.
Another relevant nding is that as the symptoms of PPD decreased,
they observed an improvement in bonding, especially with children
under 12 months old. Meanwhile, among rst-time mothers with PPD,
the symptomatic reduction occurred more rapidly with the intervention
of CBT. The results obtained provide specic data for clinical decision-
making when treating PPD.
It is important to mention that, for the symptoms of severe
depression, CBT is most effective when it is in-person and individualized,
and combined with complementary treatment such as pharmacological
treatment, as this modality has demonstrated sustained long-term results,
promoting levels of commitment and personal satisfaction, since one of
the areas focused on in the treatment is the creation of support networks.
Finally, it is concluded that CBT is a very useful therapeutic tool in
any modality, whether individual, group, or digital. Each has its benets
depending on the culture in which they are found, achieving benets such
as symptomatic relief, exibility, adaptability, improved bonding, among
others.
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5. Contribution of the authors
Future research would be advisable to include more representative
samples that encompass greater demographic, cultural, and socioeconomic
diversity. This would allow for more generalizable ndings and a more
precise understanding of how different groups respond to therapeutic
interventions.
Likewise, it is relevant to explore the effectiveness of combined
interventions that integrate different therapeutic approaches. Evaluating
these strategies could provide valuable information on more personalized
and effective treatments for postpartum depression, thereby optimizing
clinical outcomes and tailoring them to the specic needs of each patient.
6. Acknowledgments
This research was conducted thanks to a Master’s degree in
Psychology with a specialization in Psychotherapy from the Catholic
University of Cuenca, from which I graduated.
And to the collaboration of the Robotics, Automation, Intelligent
and Embedded Systems Laboratory ( RobLab ) of the Catholic University
of Cuenca.
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