Postpartum mental health screening and diagnosis by obstetrician–gynecologists

Abstract

Postpartum depression (PPD) and postpartum psychosis (PPP) can impact mother, infant, and family. Obstetrician–gynecologists (ob–gyns) are often the most frequent medical contact for postpartum women, and so are in a position to identify women needing psychological care. This study assessed ob–gyns' knowledge, attitudes, and practices regarding diagnosing PPD/PPP. A survey was sent to 400 members of the American College of Obstetricians and Gynecologists who have volunteered to participate in research. Response rate was 56%. Routine screening for PPD and PPP is conducted by 72% and 30% of respondents, respectively. Personal experience (through friend, family, or self) was associated with increased screening. Perceived PPP screening barriers are similar to those found in the PPD literature: time constraints, lack of training, and lack of knowledge of diagnostic criteria. In responding to standardised vignettes, physicians were more likely to over-diagnose, than under diagnose PPD/PPP. This study is the first to provide exploratory data of ob–gyns' knowledge, attitudes, and practice regarding PPD and PPP. Ob–gyns are screening for PPD/PPP, though not universally so. Future research should identify ways to mitigate screening barriers.

Keywords:

• Childbirth
• clinical psychology
• mental health
• child adjustment
• postnatal depression

Acknowledgements

This study was supported by the Office of Medical Applications of Research, National Institutes of Health, and Grant #R60 MC 05674 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.