Peripartum mood disturbances screening: Difference between revisions
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==Screening== | ==Screening== | ||
[[Pregnancy]] and [[postpartum]] are the most vulnerable times for mothers, fathers , and [[children]], with [[psychiatric]] [[hospitalizations]] rising faster than at any other [[period]] in a woman's life. In the United States, [[postpartum depression]] is the most underdiagnosed [[obstetric]] problem.Comprehensive [[screening]] of all [[pregnant]] and [[postpartum]] women is critical since the burden of [[depression]] and other [[mental]] [[health]] problems is high for mothers and their children, and is often ignored. Despite growing awareness of the [[prevalence]] of [[prenatal]] [[mental]] [[health]] issues and their potential harmful consequences for women, babies, and families, [[perinatal]] [[mental]] [[health]] is far too often misdiagnosed, undertreated, or untreated. | [[Pregnancy]] and [[postpartum]] are the most vulnerable times for mothers, fathers , and [[children]], with [[psychiatric]] [[hospitalizations]] rising faster than at any other [[period]] in a woman's life.<ref name="pmid16724884">{{cite journal |vauthors=Sit D, Rothschild AJ, Wisner KL |title=A review of postpartum psychosis |journal=J Womens Health (Larchmt) |volume=15 |issue=4 |pages=352–68 |date=May 2006 |pmid=16724884 |pmc=3109493 |doi=10.1089/jwh.2006.15.352 |url=}}</ref> In the United States, [[postpartum depression]] is the most underdiagnosed [[obstetric]] problem.Comprehensive [[screening]] of all [[pregnant]] and [[postpartum]] women is critical since the burden of [[depression]] and other [[mental]] [[health]] problems is high for mothers and their children, and is often ignored. Despite growing awareness of the [[prevalence]] of [[prenatal]] [[mental]] [[health]] issues and their potential harmful consequences for women, babies, and families, [[perinatal]] [[mental]] [[health]] is far too often misdiagnosed, undertreated, or untreated. | ||
*The first [[prenatal]] appointment | *The first [[prenatal]] appointment | ||
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*In [[Obstetric]] and [[primary care]] settings, [[screening]] at 6 and/or 12 months is recommended. | *In [[Obstetric]] and [[primary care]] settings, [[screening]] at 6 and/or 12 months is recommended. | ||
*Woman at-risk for [[postpartum]] [[psychosis]] should see a [[psychiatrist]] even before [[delivery]] to discuss treatment options to prevent [[illness]] during the delivery and [[postpartum]] period. | *Woman at-risk for [[postpartum]] [[psychosis]] should see a [[psychiatrist]] even before [[delivery]] to discuss treatment options to prevent [[illness]] during the delivery and [[postpartum]] period. | ||
Revision as of 01:04, 5 August 2021
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Peripartum mood disturbances Microchapters |
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Differentiating Peripartum mood disturbances from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Peripartum mood disturbances screening On the Web |
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American Roentgen Ray Society Images of Peripartum mood disturbances screening |
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Risk calculators and risk factors for Peripartum mood disturbances screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunita Kumawat, M.B.B.S[2]
Overview
It is critical to identify pregnant females and new mothers with peripartum mood disturbances, because if left unidentified and untreated it may lead to devastating consequences. Several screening tools are available for postpartum depression and for postpartum psychosis, if a patient has risk factors in personal hitory or obstetrical history, then she should visit her physician at the scheduled time for the assessment of mental health. There is no specific guideline for screening of postpartum blues.
Screening
Pregnancy and postpartum are the most vulnerable times for mothers, fathers , and children, with psychiatric hospitalizations rising faster than at any other period in a woman's life.[1] In the United States, postpartum depression is the most underdiagnosed obstetric problem.Comprehensive screening of all pregnant and postpartum women is critical since the burden of depression and other mental health problems is high for mothers and their children, and is often ignored. Despite growing awareness of the prevalence of prenatal mental health issues and their potential harmful consequences for women, babies, and families, perinatal mental health is far too often misdiagnosed, undertreated, or untreated.
- The first prenatal appointment
- During the second trimester, at least once
- During the third trimester, at least once
- Obstetrical visit six weeks after delivery (or at first postpartum visit)
- In Obstetric and primary care settings, screening at 6 and/or 12 months is recommended.
- Woman at-risk for postpartum psychosis should see a psychiatrist even before delivery to discuss treatment options to prevent illness during the delivery and postpartum period.
- In the first 2-4 weeks postpartum, the woman and her family should contact a physician if they find any of these symptoms,like
- Confusion
- Strange beliefs
- Mood Swings
- Hallucinations in the new mother.
- 6-week obstetrical follow-up appointment, it is highly recommended that physicians should inquire about symptoms of postpartum psychosis.
- If the patient expresses red flags like difficulty caring for her child, confusion, poor self-care or threats to harm herself or others, a psychiatric referral should be made as soon as possible.
Depression Screening Tools[2]
- A variety of depression screening tools are available, their specificity ranges from 77% to 100%, but sensitivity varies and is the deciding factor in choosing the depression screening tool.
- The most sensitive tools are
- Edinburgh Postnatal Depression Scale
- Postpartum Depression Screening Scale
- Patient Health Questionnaire-9.
Other less sensitive and not so commonly used screening tools are given in the table below[3]
| Screening tool | Sensitivity/Specificity |
|---|---|
| Edinburgh postnatal depression scale | Sensitivity:59-100%, Specificity:49-100% |
| Postpartum Depression Screening Scale | Sensitivity:91-94%, Specificity:72-98% |
| Patient Health Questionnaire-9 | Sensitivity:75%, Specificity:90% |
| Beck Depression Inventory | Sensitivity:47.6-82%, Specificity:85.9-89% |
| Beck Depression Inventory-II | Sensitivity:56-57%, Specificity:97-100% |
| Center for Epidemiologic Studies Deppression Scale | Sensitivity:60%, Specificity:92% |
| Zung Self Rating Depression Scale | Sensitivity:45-89%, Specificity:77-88% |
References
- ↑ Sit D, Rothschild AJ, Wisner KL (May 2006). "A review of postpartum psychosis". J Womens Health (Larchmt). 15 (4): 352–68. doi:10.1089/jwh.2006.15.352. PMC 3109493. PMID 16724884.
- ↑ "Postpartum Depression Screening: Importance, Methods, Barriers, and Recommendations for Practice | American Board of Family Medicine".
- ↑ "Screening for Depression During and After Pregnancy - ACOG".