Postpartum depression: an original survey of screening practices within a healthcare system

Abstract

Objective. This study evaluated the strategies for postpartum depression (PPD) screening by surveying healthcare providers at a US academic medical centre.

Methods. A 10-question survey was administered to 251 Obstetrics/Gynaecology, Paediatrics, and Family Practice physicians, nurses and other healthcare professionals in April–June 2007. It explored PPD screening methods and familiarity with selected screening instruments (EPDS, PDSS and PHQ-9). Familiarity scores were assigned based on Likert scale ratings, from 1 (not familiar at all) to 5 (using it all the time). Score mean values and standard deviations were calculated for each screening tool, overall and across specialty and training status. Pearson chi-square analyses with discrete and categorical variables and ANOVA with continuous variables were conducted, followed by Tukey post hoc analyses to identify significant mean differences.

Results. There were 131 completed surveys. Respondents were largely unfamiliar with PPD screening instruments, although Ob/Gyn providers were significantly more aware of each tool than were Paediatrics members. Preferred screening methods were symptom review (83%) and physical examination/observation (65%). Sixty-three per cent of respondents used multiple methods. Timing of screening varied across specialties. Paediatric providers screened earliest (0–4 weeks) of all respondents.

Conclusions. Healthcare providers typically screened for PPD using a combination of clinical methods and were less familiar with standardised instruments. Uniform screening protocols across specialties and targeted educational interventions are strongly recommended to promote better detection and collaborative management of PPD.

Acknowledgements

This project received support from Department of Psychiatry and Behavioural Sciences, U.C. Davis. The authors would like to thank Blanca E. Solis, M.D. and Marion Jones, R.N. for their assistance in conducting this research, as well as all the survey participants. Partial results were presented in poster format at the U.C. Davis Medical Student Research Forum, Sacramento, in March 2008.