SynthesisBMC psychiatry2026
Digital and repetitive transcranial magnetic stimulation interventions for perinatal depression and anxiety: a systematic review.
Synthesis in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPerinatal mood and anxiety disorders (PMADs) remain undertreated despite their prevalence and consequences. Digital psychological interventions and repetitive transcranial magnetic stimulation (rTMS) have been proposed as scalable or medication-sparing options. This systematic review evaluates the effectiveness of therapist-guided digital cognitive behavioral therapy (CBT) and rTMS for perinatal depression and anxiety, with separate synthesis of efficacy and safety evidence.
methodsWe conducted a PRISMA 2020-guided systematic review of six databases (PubMed/Medline, Scopus, Web of Science, PsycINFO, Cochrane Central, Embase) from inception to 01 October 2025. Randomized controlled trials (RCTs), non-randomized trials, pilot studies, and case series were included. Case reports (n < 5) were excluded from efficacy analyses but retained for safety data extraction. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I. Narrative synthesis was necessitated by significant clinical and methodological heterogeneity; effect sizes are contextualized by baseline severity, comparator, and study quality.
resultsTwenty-nine studies (23 RCTs, 6 non-randomized) were included. Therapist-guided digital CBT demonstrated moderate-to-large effects on depressive symptoms (between-group Hedges' g 0.5-1.4) in most, but not all, trials; certainty of evidence was moderate. Self-guided digital CBT yielded smaller, inconsistent effects (g = 0.2-0.6; low certainty). Digital mindfulness interventions showed pronounced heterogeneity: five guided, culturally adapted Eastern trials reported positive effects, while six unguided Western trials found no benefit (very low certainty). For rTMS, one small sham-controlled RCT (n = 26) provided very-low-certainty efficacy evidence. Uncontrolled studies (≈ 230 pregnancies) reported large pre-post improvements but are critically confounded and cannot establish efficacy. Safety data, while reassuring in the short term, derive from limited cumulative exposure (≈ 230 pregnancies); absence of observed harm is not equivalent to evidence of safety (low certainty).
conclusionsTherapist-guided digital CBT is a well-supported intervention and should be integrated into perinatal care. Self-guided digital CBT and mindfulness apps have limited or uncertain evidence. rTMS remains experimental; large, definitive RCTs are urgently needed. Safety evidence for rTMS is insufficient to draw firm conclusions. CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.