title: Long-term outcomes of participants in a perinatal depression early detection program.
abstract: BACKGROUND
  Long-term follow-up studies are required to better understand the extent of the effectiveness of early detection programs for perinatal depression. We followed up participants in such a program to investigate the long-term depression, treatment and relationship outcomes of mothers originally identified as 'probably depressed' (screened positive).
  
  
  METHODS
  At 2 years postpartum all participants who had 'screened positive' (N=159) and a random sample of participants who had 'screened negative' were invited to participate in a mailed survey. Measures included: current mood; coping; access to treatment; quality of partner relationship; and mother-infant bonding.
  
  
  RESULTS
  Mothers originally detected as probably depressed (n=98) fared significantly worse than 'screened negative' mothers (n=101) both in terms of their higher mean depression scores (EPDS: Ms=11.0 vs. 6.4) and greater proportions categorised as probably depressed at 2 years postpartum (40% vs. 11% respectively, p<.001, phi=.33). Elevated depression symptoms at 2 years postpartum were associated with poorer partner relationships and mother-infant bonding. Moreover, there appears to be a double dose effect for women who screen positive on two occasions. Thirty-seven percent of depressed mothers did not take up treatment, frequently citing a preference for using their own resources.
  
  
  CONCLUSIONS
  Limitations include the use of self-report measures to assess depression symptoms and mother-infant bonding. Treatment data was collected retrospectively.
  
  
  CONCLUSIONS
  Despite being offered treatment options, a substantial proportion of women who screened positive had poor long-term mental health and relationship outcomes. This paper discusses some of the implications for perinatal early detection and treatment programs.
authors.affiliation: Academic Unit of Psychological Medicine, ANU Medical School, Canberra, ACT, Australia. Rebecca.Reay@act.gov.au
authors.forename: Rebecca
authors.initials: R
authors.lastname: Reay
authors.forename: Stephen
authors.initials: S
authors.lastname: Matthey
authors.forename: David
authors.initials: D
authors.lastname: Ellwood
authors.forename: Maureen
authors.initials: M
authors.lastname: Scott
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D003625:Data Collection; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D007398:Interpersonal Relations; D008403:Mass Screening; D009034:Mother-Child Relations; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult