The detection of psychiatric illness by questionnaire

The average prevalence rate of non-psychotic postpartum depression based on the results of a large number of studies is 13%. Prevalence estimates are affected by the nature of the assessment method...

Rates and risk of postpartum depression—a meta-analysis

Perinatal depression: a systematic review of prevalence and incidence.

Background We conducted a randomized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications. Methods We randomly assig...

/pdf/effect-of-treatment-of-gestational-diabetes-mellitus-on-1mgdy9b6dd.pdf

Effect of treatment of gestational diabetes mellitus on pregnancy outcomes

Background Approximately 13% of women experience postpartum depression. Early recognition is one of the most difficult challenges with this mood disorder because of how covertly it is suffered. Objectives The purpose of this meta-analysis was to update the findings of an earlier meta-analysis of postpartum depression predictors that had synthesized the results of studies conducted mostly in the 1980s. Method A meta-analysis of 84 studies published in the decade of the 1990s was conducted to determine the magnitude of the relationships between postpartum depression and various risk factors. Using the software system Advanced Basic Meta-Analysis, effect sizes were calculated three ways: unweighted, weighted by sample size, and weighted by quality index score. Results Thirteen significant predictors of postpartum depression were revealed. Ten of the 13 risk factors had moderate effect sizes while three predictors had small effect sizes. The mean effect size indicator ranges for each risk factor were as follows: prenatal depression (.44 to .46), self esteem (.45 to. 47), childcare stress (.45 to .46), prenatal anxiety (.41 to .45), life stress (.38 to .40), social support (.36 to .41), marital relationship (.38 to .39), history of previous depression (.38 to .39), infant temperament (.33 to .34), maternity blues (.25 to .31), marital status (.21 to .35), socioeconomic status (.19 to .22), and unplanned/unwanted pregnancy (.14 to .17). Conclusions Results confirmed findings of an earlier meta-analysis and in addition revealed four new predictors of postpartum depression: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy.

Predictors of postpartum depression: an update.

The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.

Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

One hundred women attending a maternity hospital antenatal clinic who were between 28 and 34 weeks gestation completed the EPDS and were then interviewed using a standardized psychiatric interview. EPDS scores were compared with RDC diagnosis of major and minor depression and with total weighted score derived from the interview. The EPDS identified all women with RDC major depression but was less effective in detecting those with RDC minor depression.

Screening for depression during pregnancy with the edinburgh depression scale (EDDS)

In a two-stage screening procedure using the Edinburgh Postnatal Depression Scale and Goldberg's Standardised Psychiatric Interview, 232 women six months after delivery were compared with control women individually matched for age, marital status and number of children, obtained from general practitioner lists, who were not pregnant nor had had a baby in the previous 12 months. No significant difference in the point prevalence of depression at six months was found between the postnatal (9.1%) and control women (8.2%) nor in the six-month period prevalence (13.8% postnatal, 13.4% controls), but a threefold higher rate of onset of depression was found within five weeks of childbirth. The possible explanations relate to the long duration of depression in women with young children, and the stressful effect of childbirth and its psychosocial sequelae.

A controlled study of the onset, duration and prevalence of postnatal depression.

Validation of the Edinburgh postnatal depression scale (EPDS) in non-postnatal women

OBJECTIVE--To determine whether counselling by health visitors is helpful in managing postnatal depression. DESIGN--Controlled, random order trial. SETTING--Health centres in Edinburgh and Livingston. PATIENTS--Sixty women identified as depressed by screening at six weeks post partum and by psychiatric interview at about 13 weeks post partum. Five women did not wish to participate, and a further five did not complete the trial. Age, social and obstetric factors, and diagnosis were similar in women who completed the trial and those who withdrew. INTERVENTION--Eight weekly counselling visits by health visitors who had been given a short training in counselling for postnatal depression. END POINT--Reduction of depression. MEASUREMENTS and main results--Standardised psychiatric interviews and a 10 point self report scale were used to identify depression before and after intervention. The psychiatrist was not told to which group women were allocated. After three months 18 (69%) of the 26 women in the treatment group had fully recovered compared with nine (38%) of the 24 in the control group. The difference between the groups was thus 32% (95% confidence interval 5 to 58). CONCLUSIONS--Counselling by health visitors is valuable in managing non-psychotic postnatal depression.

https://www.bmj.com/content/bmj/298/6668/223.full.pdf

John Cox

Papers

Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

Screening for depression during pregnancy with the edinburgh depression scale (EDDS)

A controlled study of the onset, duration and prevalence of postnatal depression.

Validation of the Edinburgh postnatal depression scale (EPDS) in non-postnatal women

Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression.