Routine screening for postpartum depression.
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.
Georgiopoulos
A M
AM
Mayo Graduate School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Bryan
T L
TL
Wollan
P
P
Yawn
B P
BP
D000293:Adolescent; D000328:Adult; D019052:Depression, Postpartum / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011181:Postnatal Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D016896:Treatment Outcome