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ABSTRACT
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Detection of PPD has become considerably more feasible with the availability of structured, well-validated,
easily administered screening measures. The Edinburgh
Postnatal Depression Scale (EPDS) is a widely used 10item questionnaire for postpartum depression that was
developed in 1987, and has been extensively validated for
antepartum and postpartum depression, with multicultural applicability. Cronbachs alpha, the widely accepted
standard of internal consistency, has been found to be
around 0.86,10 sufficiently higher than the minimum
identified standard of 0.70. The EPDS is commonly the
measure of choice when assessing for depression related
to pregnancy and childbirth.
The ten brief items from the EPDS assess sadness and
tearfulness, loss of interest, anxiety and worry, sleep deficit, self-blame, sense of being overwhelmed, and suicidal
ideation. The questionnaire can be self-administered in
less than 5 minutes. Respondents are asked to answer
the items in relation to how they have been feeling in
the past week. Responses to the 10-item screening are
scored on a 4-point scale: 0,1,2,3. Items 3 and 510 are
reverse scored (i.e., 3,2,1,0), with the total score being
the sum of all items.
Scores on the EPDS range from 0 to 30. A score of 9/10
or above has been found to be most sensitive, specific, and
predictive of antepartum and postpartum depression.11
Notably, the EPDS predicts PPD when it is administered
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RECOMMENDATIONS
Early screening and secondary prevention for PPD is beneficial to both mother and baby. As more women become
accurately identified as having symptoms of PPD, the
demand for secondary and tertiary prevention and treatment resources will increase. It will take a multidisciplinary
approach involving obstetricians, family physicians,
pediatricians, and mental health professionals to ensure
the need is met. Future research examining how varying
disciplines can work together to meet the needs of this
population of mothers will aid coordination of efforts.
REFERENCES
1.
Wisner KL, Chambers C, Sit DKY. Postpartum Depression: A major
public health problem. Journal of the American Medical Society 2006;296
(21):2616-18.
3.
Henshaw C, Foreman D, Cox J. Postnatal blues: A risk factor for
postnatal depression. Journal of Psychosomatic Obstetrics and Gynecolgy
2004;25(3-4):267-72.
2.
American Psychiatric Association. Diagnostic and Statistical Manual
for Mental Disorders, Text revision (DSM-IV-TR). Washington, DC:
American Psychiatric Press; 2000.
4.
Munk-Olsen T, Laursen TM, Pedersen CB, et al. New Parents and
Mental Disorders: A population-based register study. Journal of the American
Medical Association 2006;296(21):2582-9.
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5.
Najman JM, Andersen MJ, Bor W, et al. Postnatal Depression - Myth
and Reality: Maternal depression before and after the birth of a child. Social
Psychiatry & Psychiatric Epidemiology 2000;35(1):19-27.
6.
Goodman SH, Gotlib IH. Risk for psychopathology in the children of
depressed mothers: a developmental model for understanding mechanisms
of transmission. Psychological Review 1999;106:458-490.
7.
Petterson S, Albers A. Effects of poverty and maternal depression
on early child development. Child Development 2001;72:1794-1813.
8.
Weinberg MK, Tronick EZ. Emotional characteristics of infants associated with maternal depression and anxiety. Pediatrics 1998;102:1298-1304.
9.
Weissman MM, Pilowsky DJ, Wickramaratne PJ. Remissions in
maternal depression and child psychopathology [published correction
appears in JAMA. 2006; 296:1234]. Journal of the American Medical
Association 2006;295:138998.
10. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression:
Development of the10-item Edinburgh postnatal depression scale. British
Journal of Psychiatry 1987;150:7826.
APPENDIX A
Available Community Resources in Lancaster County
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