Screening and diagnosing postpartum depression: when and how?

Abstract

Introduction: Prevalence rates of postpartum depression (PPD) vary widely, depending on the methodological parameters used in studies: differences in study populations, diagnostic methods, and postpartum time frame. There is also no consensus on the ideal time to perform screening, on whether PPD can only be diagnosed in the early postnatal period, or on how soon after a delivery depression may be related to it. Objective: To review which instruments have been used over recent years to screen and diagnose PPD and the prevailing periods of diagnosis. Methods: Only articles published within 5 years and related exclusively to screening and diagnosis were selected. The sample comprised 22 articles. Results: The Edinburgh Posnatal Depression Scale (EPDS) was the most common screening tool, used in 68% of the sample (15 articles), followed by the Beck Depression Inventory (BDI-II) (27%, 6 articles), and the Patient Health Questionnaire-9 (PHQ-9) (18%, 4 articles). Screening time frame was reported in 21/22 articles: 0 to 3 months postpartum in 9 (43%), up to 6 months in 4 (19%), and up to 12 months or more in 8 (38%). In short, 13 articles screened during the first 6 months (59%) while only 8 (36%) screened up to 1 year. Conclusion: The most frequent PPD diagnosis tool was the EPDS, but other scales were also used. The most common period for diagnosis was up to 3 months postpartum. However, some researchers diagnosed PPD 12 months or more postpartum. Greater standardization of parameters for investigation of this disease is needed.

Postpartum Depression: Epidemiological Clinical Profile of Patients Attended In a Reference Public Maternity in Salvador-BA

“…It is a scale with the presence and intensity of depressive symptoms in the 7 days prior to its application, which is quick and simple to use, and has high sensitivity and specificity. 2,8,10,[16][17][18][19] There are few data on the disease/age or status of patients with PPD in Salvador. Furthermore, it is known that less than 25% of postpartum women have access to treatment, and only 50% of PPD cases are diagnosed during clinical exercise.…”

Perspectives on Early Screening and Prompt Intervention to Identify and Treat Maternal Perinatal Mental Health. Protocol for a Prospective Multicenter Study in Italy

“…The EPDS (Cox et al, 1987) is the most widely used screening tool for depressive symptoms during the perinatal period (de Moraes et al, 2017;Ukatu et al, 2018). It is a self-rating scale containing 10 items about symptoms of depression such as anhedonia, feelings of guilt, lethargy, sleep disturbance and suicidal ideation.…”

“…The PHQ-9 (Kroenke et al, 2001) is the first choice for depressive symptoms in non-psychiatric primary care settings (Thase, 2016) and the third most common screening tool for postpartum depression (de Moraes et al, 2017). It is a self-rating scale containing nine items about symptoms of depression such as anhedonia and low mood, in conjunction with problems concerning physical activity, appetite, concentration, energy, self-esteem, sleep and suicidal ideation.…”

Chronic Stress protection for postnatal dEpREssioN prEvention (SERENE): a protocol for an exploratory study

“…Besides being used for clinical diagnosis, the Edinburgh Postnatal Depression Scale (EPDS) is a screening tool widely used to detect and assess the severity of the depression. 11 …”