Screening for Depression in Pre- or Postnatal Women [Internet]

Excerpt

Each year between six to nine thousand Norwegian women experience depressive symptoms during pregnancy or the first year after birth. In order to supply the right treatment it is essential to identify whether the woman has a clinical depression, depressive symptoms or is downcast. This review looks at accuracy studies of screening for post- and antenatal depression as well as the effect of screening combined with interventions on depressive symptoms. Screening tests accuracy for identification of depression We identified the Edinburgh Postnatal Depression Scale (EPDS, score for 0 to 30) as the most commonly used instrument for accuracy and effect. EPDS identified 93 percent (95 % CI: 85 to 97) of the postpartum women with clinical depression. EPDS identified 78 percent (95 % CI: 68 to 97) of the postpartum women without clinical depression as healthy. Approximately 20 percent of the women without clinical depression were classifed at risk for developing depression (false positive) with the use EPDS. Effect of screening in combination with intervention for depressive symptoms The prevalence of depressive symptoms for up to six months after birth is reduced from 10 to 6 percent (95 % CI: 5 % to 8 %) with the use of a postnatal screening programme. No studies reported physical or social outcomes for the mother, and no results of negative or adverse effects of screening or intervention for the mother, child or family were identified.