Depression in pregnancy: time of screening and access to psychiatric care.
OBJECTIVE
To determine the timing of screening for postpartum depression that optimizes access to psychiatric care.


METHODS
Cross-sectional evaluation of women receiving obstetric care in a community-based medical center clinic from March to July 2006, who were screened for depression at 36 weeks gestation, delivery, and 6 weeks postpartum using the Edinburgh Postnatal Depression Scale. Positive screens generated referrals for psychiatric evaluation. The rate of positive screens for depression and psychiatric follow-up at each time point was evaluated.


RESULTS
Of the 293 patients evaluated, the distribution of the first screen which occurred during the study period was 21% at 36 weeks, 31% at delivery, and 48% at 6 weeks postpartum. The incidence of a positive screen was 5% at 36 weeks, 16% at delivery and 14% at 6 weeks postpartum. Access to psychiatric care occurred in 33% at 36 weeks, 15% at 6 weeks postpartum and 100% at delivery (p = 0.001).


CONCLUSIONS
Screening for depression in the hospital after delivery improves access to psychiatric care.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
Aiyanna
A
Burton
Sagar
S
Patel
Lillian
L
Kaminsky
Gelen Del
GD
Rosario
Roseyln
R
Young
Adriana
A
Fitzsimmons
Joseph C
JC
Canterino
D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000628:therapy*; D019052:Depression, Postpartum / Q000175:diagnosis; D004522:Educational Status; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D013997:Time Factors