Perspectives on perinatal depression and anxiety screening in primary care: a meta-synthesis

Perinatal depression and anxiety (PNDA) may result in poor emotional and physical health, detrimental to the well-being of parents and their children. Primary health professionals have a role in the early detection of PNDA through screening to mitigate these adverse impacts. This meta-synthesis aimed to investigate perspectives on perinatal depression and anxiety screening in primary care settings.

The search strategy exploring 4 key concepts: (i) the perinatal period, (ii) depression and anxiety disorders, (iii) qualitative research and (iv) screening, was conducted across Medline, PsycINFO, CINAHL and JBI databases on 3 November 2023. Included publications were written in English and reported on qualitative research exploring any perspectives of actual or hypothetical PNDA screening services in primary care settings. Studies conducted in unclear healthcare settings, focussing on screening tool validation or services peripheral to screening, were excluded. Qualitative data were thematically synthesised using an interpretivist epistemological approach.

The search yielded 8260 publications. Following duplicate removal (n = 2788) and the systematic screening of 5472 publications, 24 publications were included for data extraction. Publications explored perspectives of consumers and health professionals receiving or conducting PNDA screening. Five overarching themes were identified: 'playing detective with PNDA', 'standing up to stigma', 'setting the scene to screen', 'utility of the screening tool' and 'resources required to optimise screening services'.

Although the value of PNDA screening was acknowledged, health professionals require adequate training to conduct screening. Robust referral systems must be established to ensure impactful PNDA screening delivery.