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Routine Screening for Peripartum Depression in the Gynecologic and Pediatric Setting - Evaluation of an Adapted EPDS
Susanne Simen1, Katharina Kuscher1, Lea Schröder2
1Klinik für Psychiatrie und Psychotherapie, Paracelsus Medizinische Privatuniversität - Nürnberg, Germany.
Insights
Routine screening for peripartum depression (PD) is feasible and acceptable. The EPDS-Plus effectively identifies mothers experiencing violence, aiding in trauma-sensitive care and treatment implementation.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Mental Health
- Trauma Studies
Background:
- Peripartum depression (PD) affects a significant number of mothers.
- Routine screening for PD is not consistently implemented in clinical practice.
- Identifying mothers with experiences of violence or trauma is crucial for effective care.
Purpose of the Study:
- To assess the feasibility and acceptability of routine peripartum depression screening by gynecologists and pediatricians.
- To validate the EPDS-Plus Plus Questions (PQ) for screening experiences of violence and traumatic birth.
- To determine the association between these experiences and peripartum depression symptoms.
Main Methods:
- Prevalence of PD was assessed in 5235 women using the EPDS-Plus.
- Convergent validity of PQ was evaluated against the Childhood Trauma Questionnaire (CTQ) and Salmon's Item List (SIL).
- Association between violence/traumatic birth and PD was analyzed using chi-square tests; practitioner acceptance was qualitatively assessed.
Main Results:
- Prevalence rates for antepartum and postpartum depression were 9.94% and 10.18%, respectively.
- PQ demonstrated strong convergent validity with CTQ and SIL (p<0.001).
- A significant association was found between violence and PD, but not between traumatic birth experience and PD. Practitioner satisfaction was high.
Conclusions:
- Routine screening for peripartum depression is feasible in standard care settings.
- The EPDS-Plus effectively identifies mothers experiencing violence, enabling targeted interventions.
- Implementation of specialized peripartum mental health treatment is recommended for affected mothers.
Purpose:
The aim of the study was to investigate the feasibility and acceptability of a routine screening for peripartum depression (PD) by gynecologists and pediatricians. In addition, it was investigated whether two separate Plus Questions (PQ) of the "EPDS-Plus" are valid for screening experiences of violence or a traumatic birth and whether they can be associated with symptoms of PD.
Methods:
Using the EPDS-Plus the prevalence of PD was investigated in 5235 women. The convergent validity of the PQ with the Childhood Trauma Questionnaire (CTQ) and Salmon's Item List (SIL) was assessed using correlation analysis. The association between the experience of violence and/or traumatic birth experience and PD was subjected to the chi-square test. Furthermore, a qualitative analysis for acceptance and satisfaction by the practitioners was performed.
Results:
The prevalence was 9.94%/10.18% for antepartum/postpartum depression. The convergent validity of the PQ showed strong correlation with CTQ (p<0.001) and SIL (p<0.001). For violence and PD, a significant association was found. There was no significant association for traumatic birth experience and PD. There was a high level of satisfaction and acceptance of the EPDS-Plus questionnaire.
Conclusion:
Screening for peripartum depression is feasible in regular care and can help to identify depressed as well as potentially traumatized mothers, especially in preparing trauma-sensitive birth care and treatment. Therefore, specialized peripartum "psych" treatment for all affected mothers in all regions has to be implemented.
