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Screening for postnatal depression: not a simple task.

Susan Armstrong1, Rhonda Small

  • 1Mother & Child Health Research, La Trobe University, Melbourne, Victoria. sj2armstrong@students.latrobe.edu.au

Australian and New Zealand Journal of Public Health
|March 6, 2007
PubMed
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An established postnatal depression screening program using the Edinburgh Postnatal Depression Scale (EPDS) in rural Victoria was ineffective. The screening process had low adherence and identified fewer cases than expected, questioning its utility.

Area of Science:

  • Public Health
  • Maternal Health
  • Mental Health Screening

Background:

  • Postnatal depression is a significant concern for maternal well-being.
  • Effective screening programs are crucial for early identification and intervention.
  • The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool.

Purpose of the Study:

  • To evaluate the effectiveness of an established postnatal depression screening program in a rural Victorian setting.
  • To assess the adherence to screening protocols using the EPDS.
  • To analyze referral pathways for women identified with probable depression.

Main Methods:

  • Audit of records for 267 women giving birth in a rural shire over 12 months.
  • Collection of data on EPDS scores, parity, maternal age, and referral details.

Related Experiment Videos

  • Analysis of screening completion rates and reasons for non-completion.
  • Main Results:

    • The screening protocol was rarely achieved; only 15.5% of women were screened on all three occasions.
    • Screening rates varied significantly, with 22% never screened.
    • Identified rates of probable depression (3.1%-9.2%) were lower than statewide averages for rural women.

    Conclusions:

    • The established universal screening program was not effective in detecting probable postnatal depression.
    • Referral pathways to General Practitioners (GPs) lacked clear feedback and collaborative planning.
    • Further evidence on feasibility, acceptability, and improved outcomes is needed before recommending universal screening.