The Effectiveness of Various Postpartum Depression Treatments and the Impact of Antidepressant Drugs on Nursing Infants

Gjerdingen, Dwenda K.

doi:10.3122/jabfm.16.5.372

Cited by 52 publications

(36 citation statements)

References 90 publications

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“…Systems based variables also play a role and include infrequent follow-up visits for mothers, lack of objective, proactive monitoring of recovery, and separation of primary care and mental health services. 75 In addition, mothers of infants may experience barriers that are unique to the postpartum or early child-rearing period, such as need for childcare during mental health visits, 78 concern about medication effects on nursing infants, 79 and fear of judgment and referral to child protection. 80 Despite these numerous barriers, the opportunities afforded by postpartum depression screening and treatment are potentially vast and include not only improving the signs and symptoms of postpartum depression, but also enhancing the new mother's ability to parent, and her ability to continue to actively participate in a marriage or relationship.…”

Section: Barriers and Opportunitiesmentioning

confidence: 99%

Postpartum Depression Screening: Importance, Methods, Barriers, and Recommendations for Practice

Gjerdingen¹,

Yawn²

2007

The Journal of the American Board of Family Medicine

261

185

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Background: Postpartum depression occurs in 10% to 20% of women who have recently given birth, but fewer than half of cases are recognized. The purpose of this review is to discuss the potential benefit of mass screening for improving postpartum depression recognition and outcomes.Methods: A review of the literature was conducted by searching MEDLINE, using the key words "depression," "postpartum depression," and "mass screening." The Cochrane database was also searched for reviews on depression and postpartum depression.Results: Opportunities for routine postpartum depression screening include mothers' postpartum office visits and their infants' well-child visits. Although several depression screens have been used in postpartum women, additional studies using large representative samples are needed to identify the ideal screening tool. Depression screening plus "high-risk" feedback to providers improves the recognition of depression. However, for screening to positively impact clinical outcomes, it needs to be combined with systems-based enhanced depression care that provides accurate diagnoses, strong collaborative relationships between primary care and mental health providers, and longitudinal case management, to assure appropriate treatment and follow-up. Depression is common and costly, particularly for women in their childbearing years. The World Health Organization has identified major depression as the fourth leading cause of burden among all diseases, and the leading cause of years lived with disability. Conclusions: Postpartum depression screening improves recognition of the disorder, but improvement in clinical outcomes1 It is estimated that depression costs the United States $30 billion to $50 billion in lost productivity and direct medical costs each year.2 By 2020, depressive illness is expected to be the second leading cause of disability in the world.3 The burden is greatest for women, with a lifetime risk for major depressive disorder of 20% to 25%, approximately twice the 7% to 12% rate seen with men. 4 In the first 3 months after childbirth, 14.5% of women have a new episode of major or minor depression, 5 and 10% to 20% of mothers are believed to suffer with depression sometime during their postpartum course, 6 making postpartum depression the most common serious postpartum disorder.There is some controversy about whether rates of depression increase after delivery, and whether postpartum depression is a distinct entity from nonpostpartum depression. A British case-control study of mothers from 4 general practices found a 3-fold higher incidence of depression within 5 weeks after childbirth.7 Similarly, a Norwegian study comparing postpartum with nonpostpartum women found a 1.8-fold greater risk for depression in postpartum women.8 However, other researchers have not found the risk of depression to be an higher in postpartum women, compared with other young women, suggesting that postpartum depression may not be a distinct condition but merely major depression recognized at a time of potentia...

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Section: Barriers and Opportunitiesmentioning

confidence: 99%

Postpartum Depression Screening: Importance, Methods, Barriers, and Recommendations for Practice

Gjerdingen¹,

Yawn²

2007

The Journal of the American Board of Family Medicine

261

185

View full text Add to dashboard Cite

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“…We also examined the references of earlier reviews on psychological treatment of PPD (Dennis, 2004;Dennis & Creedy, 2004;Gjerdingen, 2003;Lumley et al, 2004;Murray & Cooper, 1997;Richards, 1990), and we reviewed the reference lists of retrieved articles. We contacted the authors of studies that met inclusion criteria and asked whether they knew of any other (published and unpublished) studies in the field.…”

Section: Search Strategy and Selection Of Studiesmentioning

confidence: 99%

Psychological treatment of postpartum depression: a meta‐analysis

2007

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Postpartum depression is a widespread and disruptive depressive disorder seriously affecting the lives of new mothers and their families. We conducted a meta-analysis of controlled and comparative studies of psychological treatments of postpartum depression. Seventeen studies were included. The mean standardized effect size of all psychological treatments compared to control conditions was 0.61 (95% CI: 0.37$0.85). Several subgroup analyses were conducted. Studies with waiting list control groups had a larger mean effect size (0.96; 95% CI: 0.63$1.29) than studies with a care-asusual control group (0.41; 95% CI: 0.25$0.58). No definite conclusions can be drawn about the longer term effects. Too few studies were available to draw conclusions about the relative effects of psychological treatments compared to pharmacological and other treatments.

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“…This being the case, professionals tend to avoid talking about PPD because, if detected, the professionals are unclear as to the next steps to take (Gjerdingen, 2003).…”

Section: Barriers To Carementioning

confidence: 99%

Desired assistance versus care received for postpartum depression: access to care differences by race

Zittel-Palamara

Rockmaker²,

Schwabel³

et al. 2008

Arch Womens Ment Health

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One in seven women who have a baby will experience postpartum depression. Although there are many treatments for postpartum depression, many women do not receive assistance. When left untreated, this condition can have a deleterious affect on the woman's health/mental health, the child's cognitive, psychological, emotional and social development, the marital relationship and ability to contribute to society. This study examined 45 women's self-reported desire for PPD care and ability to obtain these services in Erie County, New York. Results showed differences in desired care by race, differences in access to care by race and revealed the lack of PPD care in general.

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The Effectiveness of Various Postpartum Depression Treatments and the Impact of Antidepressant Drugs on Nursing Infants

Cited by 52 publications

References 90 publications

Postpartum Depression Screening: Importance, Methods, Barriers, and Recommendations for Practice

Postpartum Depression Screening: Importance, Methods, Barriers, and Recommendations for Practice

Psychological treatment of postpartum depression: a meta‐analysis

Desired assistance versus care received for postpartum depression: access to care differences by race

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