Mobile Health for Perinatal Depression and Anxiety: Scoping Review

Abstract

Background The perinatal period is a vulnerable time during which depression and anxiety commonly occur. If left untreated or undertreated, there may be significant adverse effects; therefore, access to rapid, effective treatment is essential. Treatments for mild-to-moderate symptoms according to a stepped-care approach involve psychoeducation, peer support, and psychological therapy, all of which have been shown to be efficaciously delivered through digital means. Women experience significant barriers to care because of system- and individual-level factors, such as cost, accessibility, and availability of childcare. The use of mobile phones is widespread in this population, and the delivery of mental health services via mobile phones has been suggested as a means of reducing barriers. Objective This study aimed to understand the extent, range, and nature of mobile health (mHealth) tools for prevention, screening, and treatment of perinatal depression and anxiety in order to identify gaps and inform opportunities for future work. Methods Using a scoping review framework, 4 databases were searched for terms related to mobile phones, perinatal period, and either depression or anxiety. A total of 477 unique records were retrieved, 81 of which were reviewed by full text. Peer-reviewed publications were included if they described the population as women pregnant or up to 1 year postpartum and a tool explicitly delivered via a mobile phone for preventing, screening, or treating depression or anxiety. Studies published in 2007 or earlier, not in English, or as case reports were excluded. Results A total of 26 publications describing 22 unique studies were included (77% published after 2017). mHealth apps were slightly more common than texting-based interventions (12/22, 54% vs 10/22, 45%). Most tools were for either depression (12/22, 54%) or anxiety and depression (9/22, 41%); 1 tool was for anxiety only (1/22, 4%). Interventions starting in pregnancy and continuing into the postpartum period were rare (2/22, 9%). Tools were for prevention (10/22, 45%), screening (6/22, 27%), and treatment (6/22, 27%). Interventions delivered included psychoeducation (16/22, 73%), peer support (4/22, 18%), and psychological therapy (4/22, 18%). Cost was measured in 14% (3/22) studies. Conclusions Future work in this growing area should incorporate active psychological treatment, address continuity of care across the perinatal period, and consider clinical sustainability to realize the potential of mHealth.

Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study

“… 38 A gap in mobile phone-based interventions targeting PNA prevention, screening and/or management also seems apparent. 39 Our study did highlight the role and function of support networks and identified key members, including: family, existing friends, peer support group members and/or HCPs. Women in our study tended to gravitate towards members of their social network who could offer empathy based on shared experiences, which echoes the ‘leaning towards peer-support’ described by Walker et al 40 in the context of people experiencing mental health crises.…”

mHealth and Perinatal Depression in Low-and Middle-Income Countries: A Scoping Review of the Literature

“…These five studies have shown that both qualitative perceptions of depressive symptoms and quantitative scores of depressive symptoms improved after interventions using mobile phones. While these early studies are promising, more research needs to be conducted with respect to women living in resource-poor settings, particularly in more rural areas, who typically do not have access to specialty perinatal health services that are more easily accessible in urban centers [ 53 ]. This work is especially important given that at least half of the world’s population cannot access basic health services [ 54 ].…”

Perinatal Predictors of Postpartum Depression: Results of a Retrospective Comparative Study

“…Numerous pharmacotherapy limitations have to be regarded in pregnant women. However, there are various forms of psychotherapy, such as cognitive behavioral therapy, mindfulness, interpersonal therapy and the increasing potential of telemedicine, which are completely safe in pregnancy [ 44 ]. Thitipitchayanant conducted a study in Thailand and demonstrated that women with baby blues in whom relaxation methods were used (listening to mp3 recordings three times a day) had much lower levels of allopregnanolone.…”