Postpartum depression screening: Treatment engagement, barriers to care, and change in depressive symptoms

BACKGROUND: Postpartum depression (PPD) is a common condition associated with childbirth, yet many women do not receive the treatment they need. Despite the growing practice of PPD screening, treatment and clinical outcomes among patients identified as likely having PPD remain unclear.

METHOD: Women who were systematically screened and scored ≥12 on the Edinburgh Postnatal Depression Scale (EPDS)—indicative of possible PPD—at their routine 6-week postpartum visit were eligible to participate and were contacted after 3 months for a follow-up interview and assessment.

RESULTS: A total of 33 women participated in the study, out of 100 who scored ≥12 on the EPDS. Among the participants, 70% reported they received a referral to a health care provider for PPD, and nearly one-half said that they received psychotherapy and/or were prescribed a psychotropic. The 2 most commonly described barriers to treatment were perceptions of not needing or wanting help and concerns about breastfeeding while taking psychotropics. Nearly 40% of women scored ≥12 on the EPDS at the follow-up interview.

CONCLUSIONS: Further systematic research on outcomes after PPD screening is needed to ensure that screening translates into meaningfully improved clinical outcomes.

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