Postpartum Depression Screening

Screening for Postpartum Depression

Postpartum depression is a severe condition that has a number of different risk factors associated with developing it. Postpartum depression can affect different women differently and at different points during the postpartum period.

With as many as 20% of women experiencing mild to severe forms of clinically diagnosed postpartum depression, it is vital that postpartum depression screening tools be used to assess a woman’s risk of developing this condition. This is an especially urgent health concern as it is estimated that the real rate of postpartum depression is possibly double what is actually reported and diagnosed.

What is Postpartum Depression Screening?

Postpartum depression screening is the action taken after childbirth or at first sign of depressive symptoms in order to assess the risk of developing postpartum depression. Postpartum depression screening is a tool that can take many forms and helps support medical professionals in making a judgement or diagnosis when it comes to postpartum depression and the identification of “high-risk” women.

Postpartum depression screening was developed in response to the growing awareness surrounding the effects of postpartum depression as well as its prevalence in today’s new mothers. Postpartum depression screening aims to make an early identification of postpartum depression in order to help protect and manage the health of the mother, her family as well as her newborn child.

What Does Postpartum Depression Screening Look For?

Postpartum depression screening looks for a number of specific elements regarding the development of PPD. Here are some of the items that postpartum depression screening aims to identify:

Initial Signs of Depression

First and foremost, postpartum depression screening is used to help identify a set of initial depression symptoms in new mothers. From this initial symptom recognition, further examination can be performed and her health risk can be assessed.

Severity of Symptoms

In addition to simply identifying postpartum depression symptoms themselves, the screening tools also help medical professionals to better understand the extent of the symptoms. This includes the severity of the symptoms and how many possible symptoms are affecting the new mother in question.

For example, a postpartum depression screening test could help medical professionals predict if a mother’s initial symptoms are likely the milder “baby blues” or if they will potentially develop into full clinical postpartum depression at some point.

Timeframe

Specific postpartum depression screening tools also focus on the timeframe surrounding when the signs and symptoms developed as well as how they long have lasted – whether they have stopped, changed or are progressing with time.

This timeframe assessment of symptoms development further helps medical professionals narrow down a diagnosis. It does this by helping them to distinguish between postpartum depression and other possible conditions that could be contributing to similar symptoms.

Specific Sets of Symptoms

Because there are different types of postpartum depression, assessing a woman’s symptoms using a postpartum depression screening tool could help medical professionals make a further judgement as to which type of PPD is affecting their patient.

If more severe symptoms are in place or thought to be at risk of developing, then medical professionals will be able to put mothers on early intervention treatment to help reduce the risk of potential harm to the mother or the child.

Risk to Baby or Mother Health

In extremely rare cases, a type of postpartum depression called postpartum psychosis develops. This severe form of PPD presents a potential risk of suicide or infanticide. Though rare, medical professionals must also be diligent in screening for the possibility of postpartum psychosis in order to protect the health and safety of their patient and the baby,

Who Performs Postpartum Depression Screening?

In an official capacity, postpartum depression screening is performed typically by the woman’s obstetrician-gynecologist (ob-gyn). Postpartum depression screening can also be performed by the family physician, a labor and delivery nurse or another type of health care provider working with the mother.

Because postpartum depression screening tools are widely available online, the woman herself or her family can also help to perform a postpartum depression screening test in an unofficial capacity. Taking postpartum depression screening tests yourself can help clarify the symptoms and timeframe which will be important information to physicians or psychiatrists who will make the eventual diagnosis.

How is Postpartum Depression Screening Performed?

There are a number of different ways to screen for postpartum depression. Postpartum depression screening tools include tests, questionnaires and other screening methods. Postpartum depression screening can be performed in the hospital, at the doctor’s office, at a psychiatrist’s office or at home online.

Today, many medical experts recommend that postpartum depression screening be performed within the first week after delivery on all women. This helps medical professionals to recognize early signs so that treatment can be implemented before symptoms get worse.

However, postpartum depression screening is still not a standard practice in many hospitals and therefore, symptoms can go largely unrecognized for weeks or months. Despite the lack of standardized PPD screening, there are many hospitals today who are making postpartum depression screening part of routine postpartum care which presents hope for the future of health care for new mothers.

Types of Postpartum Depression Screening

Because postpartum depression is such a widely underdiagnosed condition that remains relatively misunderstood, there is presently no one ideal screening tool used by medical professionals to identify initial symptoms or the risk of development.

Edinburgh Postpartum Depression Scale (EPDS)

The Edinburgh Postpartum Depression Scale (EPDS) was developed in 1987 in Scottish medical centers with the purpose of identifying depression in women who had just given birth. The EPDS is a structured 10-question screening test that asks the woman to provide responses that most accurately describe her feelings over the past 7 days.

Based on the score of the test, a medical professional is able to gauge her symptoms and make a judgement as to how her symptoms may develop. This helps to support medical best practices such as a diagnosis and an eventual treatment plan.

The EPDS is currently regarded as one of the top postpartum depression screening tools available, although it does not confirm a diagnosis nor does it guarantee a prediction.

Other postpartum depression screening tools include:

  • Postpartum Depression Screening Scale
  • Patient Health Questionnaire
  • Beck Depression Inventory

References:

  1. http://mail.ny.acog.org/website/DepressionToolKit.pdf
  2. https://womensmentalhealth.org/posts/identifying-postpartum-depression-a-three-question-screening-tool/?doing_wp_cron=1476211088.5299360752105712890625
  3. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Screening-for-Perinatal-Depression
  4. http://www.jabfm.org/content/20/3/280.full