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Postnatal depression in the community

G Hearn, A Iliff, I Jones

    The British Journal of General Practice : the Journal of the Royal College of General Practitioners
    |June 13, 1998
    PubMed
    Summary
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    The Edinburgh Postnatal Depression Scale (EPNDS) can identify more cases of postnatal depression than primary health care teams alone. Routine use of the EPNDS is recommended, especially for non-Caucasian women.

    Area of Science:

    • Perinatal mental health
    • Primary healthcare
    • Screening tools

    Background:

    • Postnatal depression affects 15% of women, often undetected by primary health care teams (PHCT).
    • Depressed women may consult more frequently, but PHCT contact numbers don't reliably indicate depression.
    • Current detection rates for postnatal depression in primary care are insufficient.

    Purpose of the Study:

    • To evaluate the Edinburgh Postnatal Depression Scale (EPNDS) for detecting undiagnosed postnatal depression.
    • To assess if PHCT contact frequency can serve as a screening indicator for postnatal depression.

    Main Methods:

    • Administered the EPNDS to 176 women during postnatal examinations.
    • Recorded PHCT contacts and mental health assessments up to 42 days postpartum.

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  • Compared EPNDS scores with PHCT's perception of maternal depression.

    • Main Results:

    • The EPNDS identified 30 women with potential depression (score ≥12), but PHCTs only recognized 13.
    • The PHCT collectively identified more cases than individual professionals, yet over half remained undetected.
    • No significant difference in PHCT contact frequency between depressed and non-depressed women.
    • Asian women showed a higher likelihood of experiencing postnatal depression.

    Conclusions:

    • The EPNDS is a more effective tool than current PHCT assessments for identifying postnatal depression.
    • Routine implementation of the EPNDS in primary care is crucial for improving detection rates.
    • Further validation of the EPNDS is urgently needed for non-Caucasian populations.