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Postpartum Depression in Special Populations: A Review

Clare, Camille A. MD, MPH*; Yeh, John MD

Obstetrical & Gynecological Survey: May 2012 - Volume 67 - Issue 5 - p 313–323
doi: 10.1097/OGX.0b013e318259cb52
CME Program: CME Review Article 15
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CME

This review article aims to define and characterize postpartum depression; to discuss the social, financial, regulatory and legal implications of the disorder; and to elucidate its impact on special groups, namely adolescents, immigrants, fathers, and those of different racial and ethnic groups. A MEDLINE review of the current literature was run on postpartum depression, using the key words postpartum depression, depression, pregnancy, peripartum, or postpartum, from the years 2000 to 2011. Postpartum depressive syndromes place women and their children at risk of suicide and infanticide if not appropriately diagnosed and treated. Screening should occur within 4 to 6 weeks postpartum. Women with a history of depression before or during pregnancy, adolescents, those with low incomes and poor social support, or with a history of substance abuse, are especially at high risk. Treatments include antidepressants and psychotherapy. The unique populations of adolescents, fathers, immigrants, and certain racial and ethnic groups require special consideration in terms of diagnosis, screening modalities, and treatment. Collaboration between obstetrical providers and behavioral health professionals can ensure improved outcomes. It was found that postpartum depression is a challenging diagnosis and may be difficult to treat. A multidisciplinary approach is warranted to prevent life-threatening consequences in mothers and their children.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After participating in this activity, physicians should be better able to diagnose postpartum depression and to analyze the social, financial, regulatory and legal implications of the disorder; and to evaluate its impact on special groups, namely adolescents, immigrants, fathers, and those of different racial and ethnic groups.

*Assistant Professor, Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY; and †Professor of Obstetrics, Gynecology and Reproductive Biology, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA

CHIEF EDITOR'S NOTE: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA PRA Category 1 CreditsTM can be earned in 2012. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors, faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: John Yeh, MD, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail: john.yeh.md@gmail.com.

© 2012 Lippincott Williams & Wilkins, Inc.