NEW YORK, Mar 27 (Reuters Health) - Screening new mothers for postpartum depression is quick and effective, a new study demonstrates, but this screening is rarely done, according to one of the study's authors.
"We want to get the word out that this is a very simple thing to do," Dr. Barbara P. Yawn, a family physician and director of research at the Olmsted Medical Center in Rochester, Minnesota, told Reuters Health.
In their study, Yawn and her colleagues evaluated the effectiveness of a 10-question screening tool called the Edinburgh Postnatal Depression Scale (EPDS). The researchers reported their findings in a recent issue of The Journal of Family Practice.
Women in the study filled out the questionnaire in the doctor's office at their 6-week postpartum checkup. Those who did not have a 6-week visit received the questionnaire by mail and were asked to return it to their doctor.
The investigators reviewed the medical records of 171 women who had abnormal scores on the EPDS and 171 women with normal scores. The women with abnormal scores were seven times more likely to be diagnosed with postpartum depression. Overall, 68 women were diagnosed with postpartum depression. Most of these diagnoses (85%) were made at the 6-week visit when the EPDS was given.
Even though her study demonstrates that screening for postpartum depression can be easy, Yawn said, it is still too rare. "The message to women is if your doctor doesn't ask, ask them," Yawn said.
As many as 50% to 60% of new mothers get the "baby blues" in the first week to 10 days after having a child. This is normal and gets better on its own. But postpartum depression, which strikes from 8% to 15% of mothers worldwide, is different, and much more serious.
The symptoms of postpartum depression--loss of interest in normally pleasurable activities, crying frequently, loss of appetite, lack of motivation, difficulty sleeping--are the same as those of depression. Postpartum depression is different from "baby blues" in that the symptoms are more severe, and they do not go away after a couple of weeks. Also, postpartum depression can begin any time within 6 months after birth.
Mothers with postpartum depression may be less able to bond with their child. In severe cases, a woman may consider harming herself or her child, and may act on this impulse.
Treatment for postpartum depression can include medication or counseling or both, and is usually very effective, according to Yawn. "With treatment, most women improve pretty rapidly within a couple of weeks," she told Reuters Health.
According to the American Academy of Family Physicians, all of the following increase a woman's risk of postpartum depression: previous postpartum depression; depression not related to pregnancy; severe premenstrual syndrome; "a difficult marriage," little support from friends or family; and stressful events occurring during pregnancy or after birth. In past studies, Yawn said, she and her colleagues have found women younger than 17, those with no other adult living in the home, and divorced women are also at higher risk.
The Journal of Family Practice 2001 |
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