Routine screening for postpartum depression

J Fam Pract. 2001 Feb;50(2):117-22.

Abstract

Background: Postpartum depression (PPD) is a common and often overlooked condition. Validated screening tools for PPD exist but are not commonly used. We present the 1-year outcome of a project to implement universal PPD screening at the 6-week postpartum visit.

Methods: Universal screening with the Edinburgh Postnatal Depression Scale (EPDS) was implemented in all community postnatal care sites. One-year outcome assessments (diagnosis and treatment of PPD) were completed for a sample of the women screened using medical record review of all care they received during the first year postpartum.

Results: Sixty-eight (20%) of the 342 women whose medical records were reviewed had been given a documented diagnosis of postpartum depression, resulting in an estimated population rate of 10.7%. Depression was diagnosed in 35% of the women with elevated EPDS scores (> or =10) compared with 5% of the women with low EPDS scores (<10) in the first year postpartum. Treatment was provided for all women diagnosed with depression, including drug therapy for 49% and counseling for 78%. Four women were hospitalized for depression. Some degree of suicidal ideation was noted on the EPDS by 48 women but acknowledged in the chart of only 10 women, including 1 with an immediate hospitalization. The rate of diagnosis of postpartum depression in this community increased from 3.7% before the routine use of EPDS screening to 10.7% following screening.

Conclusions: A high EPDS score was predictive of a diagnosis of postpartum depression, and the implementation of routine EPDS screening at 6 weeks postpartum was associated with an increase in the rate of diagnosed postpartum depression in this community.

MeSH terms

  • Adolescent
  • Adult
  • Depression, Postpartum / classification
  • Depression, Postpartum / complications
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / epidemiology
  • Depression, Postpartum / therapy
  • Female
  • Humans
  • Mass Screening / methods*
  • Middle Aged
  • Minnesota / epidemiology
  • Postnatal Care / methods*
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Suicide, Attempted / statistics & numerical data
  • Treatment Outcome