title: Postnatal depression screening in a paediatric primary care setting in Italy.
abstract: Postnatal depression is a non-psychotic depressive disorder that begins within 4 weeks of childbirth and occurs in 13% of mothers and 10% of fathers. A prospective study with the aim to evaluate the prevalence of postnatal depression by screening parents with the Edinburgh Postnatal Depression Scale (EPDS) in the Italian paediatric primary care setting was performed.
  
  
  
  Mothers and fathers of infants born between 1 February and 31 July 2012, living in Italy's Milan-1 local health unit area, represented the target population of this pilot study. Parents attending well-child visits at any of the family paediatricians' offices between 60 to 90 days postpartum were asked to participate in the screening and to fill out the EPDS questionnaire. A cut-off score of 12 was used to identify parents with postnatal depression symptoms. Maternal and paternal socio-demographic variables and information concerning pregnancy and delivery were also collected. To investigate the association between screening positivity (dependent variable) and socio-demographic variables and factors related to pregnancy and delivery, a Pearson's χ2 test was used. Moreover, a stepwise multivariate logistic regression was carried out to evaluate the risk factors that most influence the probability of suffering from postnatal depression.
  
  
  
  In all, 126 out of 2706 (4.7%, 95% CI 3.9-5.5%) mothers and 24 out of 1420 (1.7%, 95% CI 1.0-2.4%) fathers were found to be positive for depressive symptoms. Women with mood disorders and anxiety during pregnancy were at increased risk of postpartum depression (OR 22.9, 95% CI 12.1-43.4). Only 11 mothers (8.7%) positive to EPDS screening attended a psychiatric service, and for 8 of them the diagnosis of postnatal depression was confirmed.
  
  
  
  The prevalence of postnatal depression was lower than previously reported. Routine screening resulted ineffective, since few mothers found positive for depression symptoms decided to attend psychiatric services.
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, Milan, 20156, Italy. antonio.clavenna@marionegri.it.
authors.forename: Antonio
authors.identifier: 0000-0001-5536-4192
authors.initials: A
authors.lastname: Clavenna
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, Milan, 20156, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Seletti
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, Milan, 20156, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cartabia
authors.affiliation: Child and Adolescent Neuropsychiatry Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Didoni
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, Milan, 20156, Italy.
authors.forename: Filomena
authors.initials: F
authors.lastname: Fortinguerra
authors.affiliation: ATS Città Metropolitana di Milano, Milan, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sciascia
authors.affiliation: ATS Città Metropolitana di Milano, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Brivio
authors.affiliation: Direzione Socio Sanitaria, ASST Santi Paolo e Carlo, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Malnis
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, Milan, 20156, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bonati
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000453:epidemiology*; D005220:Fathers / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D010865:Pilot Projects; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Depression; Pediatrics; Physicians; Postpartum; Primary Care; Screening