Early intervention for perinatal depression.
OBJECTIVE
This study was undertaken to design a process that effectively identifies and facilitates early intervention for women in an obstetrics clinic who are at risk for postpartum depression.


METHODS
Under this new program, labeled ISIS (Identify, Screen, Intervene, Support), we educated our new obstetric patients and clinic staff about postpartum depression through patient education classes, departmental lectures, and handouts. Then, we implemented simple procedures to identify risk factors for depression at intake and screened for depressive symptoms at the 32-week visit using the Edinburgh Postnatal Depression Scale (EPDS). In addition, we facilitated treatment of at-risk or symptomatic patients with the introduction of a social work consultant in the clinic setting.


RESULTS
In an obstetric chart review, 75% of our patients were screened for depression in pregnancy. Ten percent of these women demonstrated symptoms of depression warranting further evaluation.


CONCLUSIONS
Preliminary data from our multidisciplinary approach suggest that educating, screening, and appropriately treating or referring these women can take place in a busy obstetric clinic.
Thoppil
John
J
Obstetrics and Gynecology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Tex 78236, USA. thoppil@mailblocks.com
Riutcel
Terri L
TL
Nalesnik
Sally W
SW
D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors