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Perinatal Depression: For Health Care Providers Depression is common among pregnant women and mothers with small children. In urban, high-risk populations of mothers, depression rates may reach upwards of 40% (Heneghan et al 1998). Many cases of perinatal depression go unrecognized and untreated, often with significant negative consequences for both mothers and their families. Women are especially at-risk for depressive symptoms during the perinatal period, with the greatest period of risk during pregnancy (Evans et al 2001). This webpage provides information and local resources for health and mental health providers who care for Cleveland mothers, pregnant women, and their families. |
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Perinatal Depression: For Health Care Providers Contents
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Clinical
Overview of Perinatal Depression
The
following websites provide brief overviews of perinatal depression. Some sites
only discuss postpartum depression; however, many of the same principles apply
to characteristics of and care for depression during pregnancy.
Mood and anxiety disorders during pregnancy and the postpartum period
Miriam
B. Rosenthal, MD, Associate Professor of Psychiatry and Reproductive Biology
Case
Western Reserve University
Cleveland Healthy Family/Healthy Start Perinatal Depression Project, Feelings of African American Perinatal Women.
Clinical Updates in Women's Health Care: Depression in Women
The
American College of Obstetricians and Gynecologists
Depression During and After Pregnancy; A Resource for Women, Their Families, and Friends
A free booklet produced by the the U.S. Department of Health and Human Services Administration
http://www.mchb.hrsa.gov/pregnancyandbeyond/depression
Depression in Pregnancy
Dartmouth-Hitchcock Medical
Center
http://www.dhmc.org/webpage.cfm?site_id=2&org_id=92&gsec_id=2016&sec_id=2016&item_id=2039
Depression in Women: National Mental Health Association
http://www.mentalhealthamerica.net/go/depression
Professional and consumer education in English and Spanish supported by the National Institute of Mental Health.
MedEdPPD
Summit
on Women and Depression
American Psychological Association
www.apa.org/pi/wpo/women&depression.pdf
The
U.S. Preventive Services Task Force recommends screening adults for
depression in clinical practices where systems are in place to assure accurate
diagnosis, effective treatment, and followup. Even pediatric providers are
strongly encouraged to screen their patients' parents because of the potential
negative consequences of parental mental health problems on children (Bright Futures in Practice: Mental Health Practice Guide,
2002). Several validated instruments have been developed to screen adult women
for depression. Many of these instruments have simple scoring techniques,
designed to allow for processing during an office visit.
Screening
for Depression: U.S. Preventive Services Task Force Recommendations and
Rationale
http://www.ahcpr.gov/clinic/3rduspstf/depression/depressrr.htm
Screening for Depression Across the Lifespan: A Review of Measures for Use in Primary Care Settings.
American
Academy of Family Physicians. 2002.
http://www.aafp.org/afp/20020915/1001.html
Parental Depression:
Bright Futures Mental Health Practice Guide (Vol 1)
U.S. Department of
Health and Human Services, Health Resources and Services Administration,
Maternal and Child Health Bureau.
http://www.brightfutures.org/mentalhealth/
Edinburgh Postnatal
Depression Scale
One-page, 10-item
validated screening instrument developed to assist primary care health
professionals in detecting mothers who may be suffering from perinatal
depression.
http://www.perinatalweb.org/content/view/23/81/
How to administer and
score the Edinburgh Postnatal Depression Scale
http://www.granitescientific.com/EDPS.pdf
Screening
Instruments for Management of Major Depressive Disorder in Adults
Screening tools reproduced for
consideration in local settings, with information on sensitivity and
specificity: PRIME MD Primary Care Evaluations of Mental Disorders--Depression
Questions (2 items); CES-D Center for Epidemiological Studies--Depression Scale
(5 items); Zung Depression Rating Scale (21 items); BDI Beck Depression
Inventory (21 items); MOS Medical Outcomes Study--depression questions (4
items); Ham-D Hamilton Depression Scale (21 items).
http://www.oqp.med.va.gov/cpg/MDD/MDD_cpg/content/appendices/mdd_app1.htm
The Diagnostic Interview Schedule for DSM-IV (DIS-IV).
American
Psychiatric Association.
Treatment:
Counseling and Medications
Use of psychoactive medication during pregnancy and possible effects on the fetus and newborn (RE9866).
American
Academy of Pediatrics, Committee on Drugs. Pediatrics 2000; 105: 880-7.
http://www.aap.org/policy/re9866.html
Medications for Depression:
During the Childbearing Years
National Insitute of Mental
Health. 2002.
http://www.nimh.nih.gov/publicat/medicate.cfm
PubMed
National Library of
Medicine. Search over 14 million citations for biomedical articles.
Maternal and Child
Health Library: Postpartum Depression
Annotated bibliography of
sources of information about postpartum depression.
http://www.mchlibrary.info/KnowledgePaths/kp_postpartum.html
Treatment of Depression
During Pregnancy
Chronological list of
references.
http://www.pregnancyanddepression.com
Local
Resources for Pregnant and Postpartum Women
More resources and referrals to a wide range of
health and human services in Cuyahoga County can also be found at First
Call for Help. http://www.uws.org/fcfh
Network
of Care sponsored by Lorain County Board of Mental Health contains mental health
information for providers and consumers as well as links to services. http://www.lorain.oh.networkofcare.org/mh
Handouts and Short Fact Sheets for Mothers and
Families
These handouts are already in
printable form, many with appealing layouts and graphics. Some brochures may be
ordered for little to no cost.
Depression:
What Every Woman Should Know
National Institute of Mental
Health. Brochure can be ordered; also available in pdf format.
www.nimh.nih.gov/publicat/depwomenknows.cfm
Depression
in Women
American
Academy of Family Physicians (AAFP). Patient information handout.
http://www.aafp.org/afp/990700ap/225.html
Taking
Care of Both of You: Understanding Mood Changes after the Birth of your Baby
Depression and Bipolar Support Alliance (formerly National Depressive and Manic-Depressive Association).
http://www.dbsalliance.org/site/PageServer?pagename=about_publications_postpartum
Patient
Information Sheet: Postpartum Depression
The Postpartum Stress Center,
Rosemont, PA. Two-page handout (may be copied double-sided).
http://www.postpartumstress.com/Patient%20Info%20sheet.pdf
Recognizing
Postpartum Depression: Strengthening Families Fact Sheet
National Mental Health
Association. Two-page handout (may be copied double-sided).
www1.nmha.org/children/ppd.pdf
Tips
on Healthy Parenting for Mothers with Depression: Strengthening Families Fact
Sheet
National Mental Health Association. One-page handout.
www1.nmha.org/infoctr/factsheets/HealthyParentingTips.pdf
For
Mothers: Tips for Talking with a Health Care Provider about Postpartum
Depression
http://www.postpartumstress.com/tips_for_talking_with_doc.html
La
Parte Emotional de Usted: Acostumbrandose al Perido Post Parto
(The Emotional You: Postpartum
Adjustment, Spanish)
Postpartum Education for Parents, Santa Barbara, CA.
www.sbpep.org/ppd/pepartemotionalspan.htm
The Emotional You: Postpartum Adjustment, English
Postpartum Education for Parents, Santa Barbara, CA.
http://www.sbpep.org/ppd/TheEmotionalYouBrochure.pdf
Continuing Education in Perinatal Depression
Provider Depression Page
Web-based curriculum to help health professionals learn how to identify and treat perinatal depression. Produced by the Virginia Department of Health and the University of Virginia.
http://www.perinataldepression.org
Bright
Futures in Practice: Mental Health
Early recognition and
intervention for pediatric and parental mental health problems. Mental health
tool kit contains resources for screening, care management, and health
education.
http://www.brightfutures.org/training/MH/MH_Fact_sheet.pdf
Emotional
Effects of Childbirth
Marcé Society. A course for health professionals who care for women around the time of childbirth.
http://www.marcesociety.com/distance learning.php3
The
Postpartum Stress Center Postgraduate Training Program: "Perinatal Mood Disorders Assessment and Treatment"
The Postpartum Stress Center,
Rosemont, PA. A professional course on perinatal mental health.
http://www.postpartumstress.com/Trainingsixhrgrad.pdf
The
Marcé
Society: An International Society of the Understanding, Prevention and Treatment
of Mental Illness Related to Childbearing
A multidisciplinary organization that seeks to bring together different strands of research regarding pregnancy-related mental disorders.
http://www.marcesociety.com/About.asp
Association
for Pre- & Perinatal Psychology and Health
Professional and lay organization that provides “a forum for individuals from diverse backgrounds and disciplines interested in psychological dimensions of prenatal and perinatal experiences.”
http://www.birthpsychology.com
