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Identification of Postpartum Depression

SIT, DOROTHY K. Y. MD; WISNER, KATHERINE L. MD, MS

Clinical Obstetrics & Gynecology: September 2009 - Volume 52 - Issue 3 - pp 456-468
doi: 10.1097/GRF.0b013e3181b5a57c
Psychiatric Disorders in Pregnancy

Postpartum depression (PPD) is the most common medical complication of childbearing. Universal screening maximizes the likelihood of prompt identification of PPD. Obstetrician-gynecologists routinely evaluate postpartum women for a general health examination and review of family planning options at approximately 6 weeks after birth; therefore, they are well positioned to identify PPD. In this study, we review the diagnostic criteria for postpartum depressive disorders and clinical risk factors predictive of PPD. We examine depression screening tools, appropriate cut-points associated with positive screens, the optimal timing for screening, and the acceptability of depression screening in obstetrical settings. Finally, we explore how to manage patients who screen positive for depression and treatment options for women with PPD.

Department of Psychiatry, Western Psychiatric Institute and Clinic University of Pittsburgh, Pittsburgh, Pennsylvania

Correspondence: Dorothy K. Y. Sit, MD, Assistant Professor of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Oxford Building 410, Pittsburgh, PA 15213. E-mail: sitdk@upmc.edu.

Dr Sit's contributions were supported by National Institute of Mental Health for the grants R01 MH60335 (PI: K.L. Wisner) and K23 MH082114-01A2 (PI: D. Sit), and the International Society of Bipolar Disorders Fellowship Award (PI: D. Sit). Dr Wisner's contributions were supported primarily by the National Institute of Mental Health for the following grants: R01 MH60335, R01 MH071825 and R01 MH075921 (PI: K.L. Wisner). Dr Wisner has also received grant support from the Society for Bariatric Surgery, the Heinz Foundation, the New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services, Novogyne, Pfizer, the Stanley Medical Research Foundation, and the State of Pennsylvania.

© 2009 Lippincott Williams & Wilkins, Inc.