CoChat
Sign Up
Cited by 344Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

Postpartum depression screening: importance, methods, barriers, and recommendations for practice

Open access
Gjerdingen, D. K., Yawn, B. P.·2007·The Journal of the American Board of Family Medicine
DOI 10.3122/jabfm.2007.03.060171
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Postpartum depression occurs in 10% to 20% of women who have recently given birth, but fewer than half of cases are recognized. The purpose of this review is to discuss the potential benefit of mass screening for improving postpartum depression recognition and outcomes. METHODS: A review of the literature was conducted by searching MEDLINE, using the key words "depression," "postpartum depression," and "mass screening." The Cochrane database was also searched for reviews on depression and postpartum depression. RESULTS: Opportunities for routine postpartum depression screening include mothers' postpartum office visits and their infants' well-child visits. Although several depression screens have been used in postpartum women, additional studies using large representative samples are needed to identify the ideal screening tool. Depression screening plus "high-risk" feedback to providers improves the recognition of depression. However, for screening to positively impact clinical outcomes, it needs to be combined with systems-based enhanced depression care that provides accurate diagnoses, strong collaborative relationships between primary care and mental health providers, and longitudinal case management, to assure appropriate treatment and follow-up. CONCLUSIONS: Postpartum depression screening improves recognition of the disorder, but improvement in clinical outcomes requires enhanced care that ensures adequate treatment and follow-up.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3122/jabfm.2007.03.060171

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Postpartum depression is associated with poor maternal and infant health, even when symptomatology is subclinical.

    “Evidence shows that PPD is associated with overall poor maternal (O'Hara and McCabe, 2013; Gjerdingen and Yawn, 2007; Slomian et al., 2019) and infant health (Stein et al., 2014; Slomian et al., 2019; Hayes et al., 2013; Pawlby et al., 2009), even when the symptomatology is subclinical (Tronick and Reck, 2009; Weinberg et al., 2001).”

    From App-based intervention for reducing depressive symptoms in postpartum women: Protocol for a feasibility randomized controlled trial (2023) · cites this paper as Gjerdingen and Yawn, 2007

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 97 · Cited by 344

Research works printed but not linked: 71

  1. Robinson WD, Geske JA, Prest LA, Barnacle R. Depression treatment in primary care. J Am Board Fam Pract. 2005;18:79 -86.
  2. Pignone MP, Gaynes BN, Rushton JL, et al. Screen- ing for depression in adults: a summary of the evi- dence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;136:765-76.
  3. Steiner M. Perinatal mood disorders: position paper. Psychopharmacol Bull. 1998;34:301-6.
  4. Cox JL, Murray D, Chapman G. A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry. 1993;163:27-31.
  5. Eberhard-Gran M, Tambs K, Opjordsmoen S, Skrondal A, Eskild A. A comparison of anxiety and depressive symptomatology in postpartum and non- postpartum mothers. Soc Psychiatry Psychiatr Epi- demiol. 2003;38:551-6.
  6. Wickberg B, Hwang CP. Screening for postnatal depression in a population-based Swedish sample. Acta Psychiatr Scan. 1997;95:62-6.
  7. O'Hara MW, Zekoski EM, Philipps LH, Wright EJ. Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchild- bearing women. J Abnormal Psychol. 1990;99:3-15.
  8. O'Hara MW, Schlechte JA, Lewis DA, et al. Pro- spective study of postpartum blues. Arch Gen Psych. 1991;48:801-6.
  9. Harris B. Biological and hormonal aspects of post- partum depressed mood working towards strategies for prophylaxis and treatment. Br J Psych. 1994;164: 288 -92.
  10. Kumar R. Postnatal mental illness: a transcultural perspective. Soc Psychiatry Psychiatr Epidemiol. 1994;29:250 -64.
  11. Murray L, Stein A. The effects of postnatal depres- sion on the infant. Baillieres Clin Obstet Gynaecol. 1989;3:921-33.
  12. Harris B, Othman S, Davies JA, et al. Association between postpartum thyroid dysfunction and thyroid antibodies and depression. Br Med J. 1992;305:152-6.
  13. Pop VJ, de Rooy HA, Vader HL, et al.[title] Post- partum thyroid dysfunction and depression in an unselected population. N Engl J Med. 1991;324(25): 1815-6. Erratum in: N Engl J Med. 1991;325(5): 371.
  14. Prentice LM, Phillips DI, Sarsero D, et al. Geo- graphical distribution of subclinical autoimmune thyroid disease in Britain: a study using highly sen- sitive direct assays for autoantibodies to thryoglobu- lin and thyroid peroxidase. Acta Endocrinol. 1990; 123:493-8.
  15. Henderson AF, Gregoire AJ, Kumar RD, Studd JW. Treatment to severe postnatal depression with oes- tradiol skin patches. Br J Psychiatry. 1991;338(8770): 816 -7.
  16. Feksi A, Harris B, Walker RF, Riad-Fahmy D, New- combe RG. "Maternity blues" and hormone levels in saliva. J Aff Disorders. 1984;6:355-6.
  17. Bloch M, Schmidt PJ, Danaceau M, et al. Effects of gonadal steroids in women with a history of postpar- tum depression. Am J Psychiatry. 2000;157:924 -30.
  18. Beck CT. Predictors of postpartum depression. Nurs Res. 2001;50:275-85.
  19. Grace SL, Evindar A, Stewart DE. The effect of postpartum depression on child cognitive develop- ment and behavior: a review and critical analysis of the literature. Arch Women's Mental Health. 2003; 6:263-74.
  20. Field T. Infants of depressed mothers. Infant Behav Dev. 1995;18:1-13.
  21. Tronick E, Weinberg K. Depressed mothers and infants: failure to form dyadic states of conscious- ness. In: Murray L, Cooper P, editors. Postpartum Depression and Child Development. New York: The Guilford Press; 1997.
  22. Abrams SM, Field T, Scafidi F, Prodromidis M. Newborns of depressed mothers. Infant Mental Health. J 1995;16:233-9.
  23. Weissman MM, Feder A, Pilowsky DJ, et al. De- pressed mothers coming to primary care: maternal reports of problems with their children. J Aff Disor- ders. 2004;78:93-100.
  24. Murray L. The impact of postnatal depression on infant development. J Child Psychol Psychiatry. 1992;33:543-61.
  25. Stein A, Gath DH, Bucher J, et al. The relationship between postnatal depression and mother-child in- teraction. Br J Psychiatry. 1991;158:46 -52. 286 JABFM May-June 2007 Vol. 20 No. 3 http://www.jabfm.org copyright. on 13 September 2023 by guest. Protected by http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2007.03.060171 on 3 May 2007. Downloaded from
  26. Cramer B. Are postpartum depressions a mother- infant relationship disorder? Infant Mental Health J. 1993;14:283-97.
  27. Guedeney N. A propos des meres deprimees: l;im- pact de la depression sur les interactions precoces: revue de litterature anglosaxonne. Annales de Pedia- trie. 1993;40:496 -502.
  28. Frodi A, Bridges L, Shonk S. Maternal correlates of infant temperament ratings and of infant-mother attachment: a longitudinal study. Infant Mental Health J. 1989;10:273-89.
  29. Rotnem DL. An examination of the association be- tween maternal depression and the behavioral func- tioning of school-age children. [dissertation]. Northampton (MA): Smith College School for So- cial Work, 1991. Dissertation Abstracts Interna- tional. 1991;52(1-B):156.
  30. Murray L, Cooper P. The role of infant and mater- nal factors in postpartum depression, mother-infant interactions, and infant outcome. In: Murray L, Cooper PJ, editors. Postpartum Depression and Child Development. New York: The Guilford Press; 1997.
  31. Beck, CT. The effects of postpartum depression on child development: a meta-analysis. Arch Psychiatr Nurs. 1998;12:12-20.
  32. Wolkind S. Mothers' depression and their children's attendance at medical facilities. J Psychosom Res. 1985;29:579 -82.
  33. Kolter T, Buzwell S. Romeo Y, Bowland J. Avoidant attachment as a risk factor for health. Br J Med Psych. 1994;67:237-45.
  34. Georgiopoulos AM, Bryan TL, Wollan P, Yawn BP. Routine screening for postpartum depression. J Fam Pract. 2001;50:117-22.
  35. Evins GG, Theofrasstous JP, Galvin SL. Postpartum depression: a comparison of screening and routine clinical evaluation. Am J Obstet Gynecol. 2000;182: 1080 -2.
  36. Hearn G, Iliff A, Jones I, et al. Postnatal depression in the community. Br J Gen Pract. 1998;48:1064 - 66.
  37. US Preventive Services Task Force. Screening for depression: recommendations and rationale. Ann In- tern Med. 2002;136:760 -4.
  38. Morris-Rush JK, Freda MC, Bernstein PS. Screen- ing for postpartum depression in an inner-city pop- ulation. Am J Obstet Gynecol. 2003;188:1217-9.
  39. Chaudron LH, Szilagyi PG, Kitzman HJ, Wadkins HIM, Conwell Y. Detection of postpartum depres- sive symptoms by screening at well-child visits. Pe- diatrics. 2004;113:551-8.
  40. Heneghan AM, Silver EJ, Bauman LJ, Stein REK. Do pediatricians recognize mothers with depressive symptoms? Pediatrics. 2000;106:1367-73.
  41. Buist A, Condon J, Brooks J, et al. Acceptability of routine screening for perinatal depression. J Aff Dis- orders. 2006;93:233-7.
  42. Gemmill AW, Leigh B, Ericksen J, Milgrom J. A survey of the clinical acceptability of screening for postnatal depression in depressed and non-depressed women. BMC Pub Health. 2006;6:211.
  43. Kelly BD. St John's wort for depression: what's the evidence?. Hosp Med. 2001;62:274 -6.
  44. Seehusen DA, Baldwin LM, Runkle GP, Clark G. Are family physicians appropriately screening for postpartum depression? J Am Board Fam Med. 2005; 18:104 -12.
  45. Spitzer RL, Kroenke K, Williams JBW, et al. Vali- dation and utility of a self-report version of PRIME- MD: The PHQ primary care study. JAMA. 1999; 282:1737-44.
  46. Yawn BP. Postpartum Depression, Part 1: Preva- lence and Considerations in Screening. The Female Patient. 2006;31:37-42.
  47. Olson AL, Kemper KJ, Kelleher KJ, Hammond CS, Zuckerman BS, Dietrich AJ. Primary care pediatri- cians' roles and perceived responsibilities in the identification and management of maternal depres- sion. Pediatrics. 2002;110:1169 -76.
  48. Guirguis-Blake J, Fryer GE, Deutchman M, Green LA, Dovey SM, Phillips RL. Family physicians in- crease provision of well-infant care despite decline in prenatal services. Am Fam Physician. 2003;67:17.
  49. Georgiopoulos AM, Bryan TL, Yawn BP, Houston MS, Rummans TA, Therneau TM. Population- based screening for postpartum depression. Obstet Gynecol. 1999;93:653-7.
  50. Bryan TL, Georgiopoulos AM, Harms RW. Hux- sahl JE, Larson DR, Yawn BP. Incidence of postpar- tum depression in Olmsted County, Minnesota. A population-based, retrospective study. J Reprod Med. 1999;44:351-8.
  51. Gordon TE, Cardone IA, Kim JJ, Gordon SM, Sil- ver RK. Universal perinatal depression screening in an Academic Medical Center. Obstet Gynecol. 2006; 107:342-7.
  52. Freeman MP, Wright R, Watchman M, et al. Post- partum depression assessments at well-baby visits: doi: 10.3122/jabfm.2007.03.060171 Postpartum Depression Screening 287 copyright. on 13 September 2023 by guest. Protected by http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2007.03.060171 on 3 May 2007. Downloaded from screening feasibility, prevalence, and risk factors. J Womens Health. 2005;14:929 -35.
  53. Currie ML, Rademacher R. The pediatrician's role in recognizing and intervening in postpartum de- pression. Pediatr Clin North Am. 2004;51:785-801.
  54. Bethell C, Reuland CHP, Halfon N, Schor EL. Measuring the quality of preventive and develop- mental services for young children: national esti- mates and patterns of clinicians' performance. Pedi- atrics. 2004;113:1973-83.
  55. Wiley CC, Burke GS, Gill PA, Law NE. Pediatri- cians' views of postpartum depression: a self-admin- istered survey. Arch Womens Mental Health. 2004; 7:231-6.
  56. Austin MP, Lumley J. Antenatal screening for post- natal depression: a systematic review. Acta Psychiatr Scand. 2003;107:10 -17.
  57. Nease DE, Malouin JM. Depression screening: a practical strategy. J Fam Pract. 2003;52:118 -26.
  58. Scholle SH, Haskett RF, Janusa BH, Pincus HA, Kupfer DJ. Addressing depression in obstetrics/ gynecology practice. Gen Hosp Psychiatry. 2003;25: 83-90.
  59. Kroenke K, Spitzer RL, Williams JBW. The Patient Health Questionnaire-2. Validity of a two-item de- pression screener. Med Care. 2003;41:1284 -92.
  60. Nutting PA, Rost K, Dickinson M, et al. Barriers to initiating depression treatment in primary care prac- tice. J Gen Intern Med. 2002;17:103-11.
  61. Katon WJ, Ludman EJ. Improving services for women with depression in primary care settings. Psychol Women Quarterly. 2003;27:114 -20.
  62. Williams JW, Rost K, Dietrich AJ, Ciotti MC, Zyzanski SJ. Primary care physicians' approach to depressive disorders. Arch Fam Med. 1999;8:58 -67.
  63. LaRocco-Cockburn A, Melville J, Bell M, Katon W. Depression screening attitudes and practices among obstetrician-gynecologists. Obstet Gynecol. 2003; 101:892-8.
  64. Ugarriza DN. Group therapy and its barriers for women suffering from postpartum depression. Arch Psychiatr. Nurs. 2004;18:39 -48.
  65. Gjerdingen D. The effectiveness of various postpar- tum depression treatments and the impact of antide- pressant drugs on nursing infants. J Am Board Fam Pract. 2003;16:372-82.
  66. Heneghan AM, Mercer MB, Deleone NL. Will mothers discuss parenting stress and depressive symptoms with their child's pediatrician? Pediatrics. 2004;113:460 -7.
  67. Murray L, Sinclair D, Cooper P, et al. The socio- emotional development of 5-year-old children of postnatally depressed mothers. J Child Psychiatry. 1999;40:1259 -71.
  68. Zelkowitz P, Milet TH. Screening for post-partum depression in a community sample. Can J Psychiatry. 1995;40:80 -6.
  69. Wang SY, Chen CH, Chin CC, Lee SL. Impact of postpartum depression on the mother-infant couple. Birth. 2005;32:39 -44.
  70. Ramsay M, Gisel EG, McCusker J, Bellavance F, Platt R. Infant sucking ability, non-organic failure to thrive, maternal characteristics, and feeding prac- tices: a prospective cohort study. Dev Med Child Neurol. 2002;44:405-14.
  71. Hay DF, Pawlby S, Sharp D, et al. Intellectual prob- lems shown by 11-year-old children whose mothers had postnatal depression. J Child Psychiatry. 2001; 42:871-89.

Authors
Gjerdingen, D. K., & Yawn, B. P.
Affiliations
University of Minnesota (US)
ORCID
Yawn, B. P.
Venue
The Journal of the American Board of Family Medicine
Publisher
American Board of Family Medicine (ABFM)
Published
2007-05-01
Volume
20
Issue
3
Pages
280-288
ISSN
  • 1557-2625 (ISSN-L)
  • 1558-7118
DOI
10.3122/jabfm.2007.03.060171
OpenAlex
W2108609361
Cited by
344
References
97
Citations by year
2026: 12 · 2025: 17 · 2024: 13 · 2023: 15 · 2022: 15 · 2021: 20 · 2020: 17 · 2019: 20 · 2018: 18 · 2017: 23 · 2016: 19 · 2015: 24 · 2014: 16 · 2013: 25 · 2012: 15
FWCI
2.87
Type
journal article
Language
en
Open access
Locations
  • The Journal of the American Board of Family Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
postpartum depression, depression screening, mass screening, screening tool, primary care, case management, barriers to screening
MeSH terms
Female, Humans, Practice Patterns, Physicians', United States, Guidelines as Topic, Depression, Postpartum

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review