JMIR Publications

ABSTRACT

Background:

The perinatal period is a vulnerable time during which depression and anxiety commonly occur. Left untreated or under-treated, 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 due to system and individual level factors, such as cost, accessibility, and availability of childcare. The use of mobile phones is widespread in this population, and delivery of mental health services via mobile phones has been suggested as a means of reducing barriers.

Objective:

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 depression/anxiety. 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 for preventing, screening, or treating depression/anxiety explicitly delivered via mobile phone. Studies published in 2007 or earlier, not in English, or as case reports were excluded.

Results:

26 publications describing 22 unique studies were included (77.3% published after 2017). mHealth applications (apps) were slightly more common than texting-based interventions (n=12, 54.5% vs n=10, 45.5%). Most tools were for depression only (n=12, 54.5%) or anxiety and depression (n=9, 41.0%); one was for anxiety only (4.5%). Interventions were rarely for use starting in pregnancy and continuing into postpartum (n=2, 9%). Tools were for prevention (n=10, 45.5%), screening (n=6, 27.3%), and treatment (n=6, 27.3%). Interventions delivered included psychoeducation (n=16, 72.7%), peer support (n=4, 18.2%), and psychological therapy (n=4, 18.2%). Cost was measured in 3 (14%) 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 mHealth’s potential.