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Screen pregnant women for psychiatric disorders, say researchers

There should be routine psychiatric screening in pregnant women so that treatment can begin earlier and post-partum depression can be averted, say researchers.

The study

Women who had given birth in the maternity ward at Magee-Women’s Hospital were visited on the ward and offered screening by phone at four to six weeks post-partum. All women who were reached by phone and who had screen-positive findings, defined as an Edinburgh Postnatal Depression Score of 10 or more, were offered a home visit evaluation for psychiatric diagnostic assessment. A total of 10,000 women underwent phone screening, with 826 of the 1,396 screened positive accepting a home visit.

The findings

Episode onset was most frequent in the post-partum period, with 40.1% of the 826 women visited experiencing a depressive episode in the first four weeks after giving birth. 33.4% experienced an episode during pregnancy and 26.5% before pregnancy. The most common primary diagnoses in visited women were unipolar disorders, with 68.5% having at least one unipolar episode. 22.6% experienced bipolar disorder and 5.6% an anxiety disorder.

What does it mean for GPs?

The US researchers concluded that ‘these data suggest consideration of screening during pregnancy to identify psychiatric disorders and intervene earlier in the episode course.’ They added that a ‘comprehensive screening and diagnostic characterisation coupled with diagnosis-specific intervention strategies might reduce maternal disability, improve function and avert a new generation risk.’

JAMA Psychiatry 2013, online 13 March