Postpartum Depression Screening: NIMH funded study

Objective: Postpartum depression screening is required in two states and the MOTHERS Act (pending in the Senate) may expand this requirement. The objective was collection of data to drive screening methodology and service development.

Methods. Screening was offered to all women who delivered at the University of Pittsburgh Magee Womens Hospital (9,000 births/year). Screening was done by phone at 4-6 weeks post-birth with the Edinburgh Postnatal Depression Screening Scale (EPDS). Mothers who scored >10 on the EPDS had an in-home psychiatric diagnostic evaluation to identify disorders associated with positive screens and clarify episode onset relative to childbearing.

Results: Positive screens were found in 13.8% of women. Home visits (N=328) have been completed and the diagnoses were: 1) Major depression, N=225 (69%); Bipolar Disorder, N=59 (18%); Anxiety Disorder, N=30 (9%); Substance Use Disorder, N=1 (0.3%); Other, N=7 (2%); No diagnosis, N=6 (2%). The onset of the identified episodes was: during pregnancy, N=90 (27%); postpartum (within 4 weeks of birth), N=121 (37%); and prior to pregnancy, N=117 (36%).

Conclusions: Although 69% of the women had major depression, a positive EPDS identified other major disorders, particularly bipolar and anxiety disorders. Post-birth screening identified a majority (63%) of women who had longer term episodes (illness onset either during pregnancy or prior to the index pregnancy). Early onset comorbidities were common: Of 328 subjects, women with anxiety disorders =172 (over half), with substance abuse/dependence=64 (nearly 20%) and women with eating disorders=31 (nearly 10%); numbers are not mutually exclusive with respect to comorbidities.