Screening practices of physicians for postpartum depression: A review of current literature

Postpartum depression (PPD), affecting an estimated 10-20% of mothers with the first year after their infant is born, is the most common complication of childbirth and most cases remain undetected by providers.  Pediatricians, obstetricians/gynecologists, and family practitioners have a responsibility to identify PPD as the condition has long-term adverse effects on their patients.  This literature review explores and summarizes studies on the screening practices of physicians, identifies when screening occurs, and highlights why it is not routinely practiced.  In general, physicians were more likely to screen for PPD if they used multiple screening methods, found screening to be easy, had positive attitudes towards PPD screening, and had positive perceptions of mental health services.  Furthermore, the likelihood of screening for PPD was higher in physicians who felt responsible for recognizing, treating, or managing PPD, were confident in their PPD management skills, and perceived fewer barriers to screening.  Overall, obstetricians/gynecologists and family practitioners, compared to pediatricians, were more likely to screen and had more training and confidence in their ability to manage PPD.  Pediatricians were less likely to screen yet have the most interactions with postpartum women.  Pediatricians, therefore, could have the greatest impact on PPD detection rates. Training and continuing education had a variety of effects on practice by increasing perceived self-efficacy and responsibility to screen.  In conclusion, educating physicians about PPD and training them on the ease of routinely using a validated screening tool to identify PPD can increase screening rates.