Psychological Comorbidities in Women Having Diastasis Recti – Narrative Review

Abstract

Background: Diastasis recti abdominis (DRA), defined as the separation of the rectus abdominis muscles along the linea alba, is a common condition during pregnancy and the postpartum period. While its physical manifestations, such as impaired core stability and musculoskeletal discomfort, are well-documented, the associated psychological comorbidities remain underexplored. Anxiety, depression, and body image concerns have been observed in affected women, but systematic synthesis of these outcomes is limited. Objective: This review aimed to synthesize the available evidence on psychological comorbidities associated with DRA, explore their impact on quality of life, and highlight potential psychosocial and clinical interventions to address this burden. Methods: A narrative review methodology was applied. Literature searches were performed in PubMed, Scopus, PsycINFO, and Google Scholar using combinations of the terms “diastasis recti,” “abdominal separation,” “psychological comorbidities,” “anxiety,” “depression,” and “body image.” Eligible studies included observational research, qualitative studies, systematic reviews, and interventional reports that examined psychological or quality of life outcomes in women with DRA. Articles focusing solely on surgical techniques or physical rehabilitation without mental health assessment were excluded. Data were synthesized narratively, emphasizing recurring psychological themes, risk factors, and reported interventions. Results: The review identified consistent associations between DRA and psychological comorbidities, particularly anxiety, depression, and body image disturbance. These factors contributed to reduced self-esteem, social withdrawal, and impaired quality of life. Postpartum vulnerability, exacerbated by hormonal changes, sleep deprivation, and caregiving stress, intensified psychological symptoms. Risk factors included multiple pregnancies, sociocultural norms emphasizing rapid body recovery, and lack of social support. Evidence for psychosocial interventions such as psychoeducation, counseling, cognitive-behavioural therapy, and mindfulness was promising but limited, with most studies extrapolated from broader postpartum literature rather than DRA-specific trials. Conclusion: DRA has significant psychological as well as physical consequences, underscoring the need for holistic and multidisciplinary care. Early recognition of psychological comorbidities and integration of psychosocial interventions into physiotherapy and medical management may improve overall outcomes. Future research should prioritize longitudinal designs, culturally.