The US Preventive Services Task Force issued an updated recommendation for screening all adults for depression. The last update, in 2009, did not recommend screening all adults over 18 but the 2016 update does. Depression in anyone 15 and older is one of the leading causes of disability in the US.
Screening Recommended for Expectant and New Mothers
The 2016 update also stresses the value of depression screening for all women who are pregnant and who have given birth in the previous year. The task force based this update on recommendations from the American Academy of Family Physicians, the American Congress of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics.
Screen here for postpartum depression with the Edinburgh Depression Score.
What Is Perinatal Depression?
Perinatal depression is one of the most common medical complications of pregnancy, affecting as many as one in seven women, according to the ACOG. These episodes can be major or minor, occurring during pregnancy or in the 12 months following childbirth. Depression is often accompanied by anxiety, fear, and feelings of hopelessness that affect the woman, her new baby, and the rest of her family. The risk of depression-related maternal suicide is greater than the risk for hemorrhage and hypertensive disorders that include preeclampsia.
Women suffering from perinatal depression often experience a heightened sense of stress, fatigue, fearfulness, and anxiety. She may neglect the pregnancy, and experience relationship difficulties. Labor and childbirth can be especially traumatic to a depressed mother, who might later have difficulty breastfeeding and bonding with her newborn. A new mother’s depression can diminish the quality of life for her entire family.
Babies born to mothers suffering from perinatal depression are at increased risk of preterm delivery and other complications of birth, more frequent NICU admissions, and failure to thrive.
Screening for Depression
The standard method of screening, recommended now for all adults age 18 or older, is a self-completed questionnaire that explores an individual’s mental and emotional state of health and lifestyle factors such as quality of sleep, appetite, interest in social activities, and thoughts of self-harm in the two weeks prior to screening. These screening tools can be administered by any doctor, including family physicians, obstetricians, and gynecologists. The task force recommendation is that every woman be screened for depression at least once during pregnancy.
Treating Perinatal Depression
When perinatal pregnancy is diagnosed, it can often be treated with lifestyle interventions that include improved diet, regular moderate exercise, better sleep, and talk therapy. In extreme cases, medications can be prescribed. Many pregnant and nursing women hesitate to take antidepressants during the perinatal period but repeated studies have shown that treating depression, even with medications, is better for both mothers and babies, rather than letting it go untreated during this very important stage of life.
The latest issue of the Journal of the American Medical Association (JAMA) carries the update and is accompanied by an editorial praising the update by Dr. Michael E. Thase, a professor of psychiatry affiliated with the Corporal Michael J. Crescenz Veterans Affairs Medical Center and the University of Pennsylvania, both in Philadelphia.
"Final Recommendation Statement / Depression in Adults: Screening." US Preventive Services Task Force. US Preventive Services Task Force, Jan. 2016. Web. 26 Jan. 2016.
Committee on Obstetric Practice. "Committee Opinion: Screening for Perinatal Depression." ACOG. The American College of Obstetricians and Gynecologists, May 2015. Web. 26 Jan. 2016.
Siu, Albert L, and the US Preventive Services Task Force (USPSTF). "Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement." JAMA. American Medical Association, 26 Jan. 2016. The JAMA Network. Web. 26 Jan. 2016.
Storrs, Carina. "Doctors should screen pregnant women, new moms for depression, task force recommends." CNN Health. Cable News Network / Turner Broadcasting System, Inc., 26 Jan. 2016. Web. 26 Jan. 2016.