Findings from new research have just been published in the journal Pediatrics, giving another evidence-based boost to the argument that pediatricians can and must screen and refer for postpartum depression.
From United Press International (UPI):
A study published in this month's issue of the journal Pediatrics says asking whether a mother has lost interest and pleasure in doing things lately -- and whether she has been feeling down -- can quickly start the process of getting help for the estimated 10 percent of mothers who are depressed. Researchers reported last month that the children of very depressed parents remain about three times as likely as their peers to suffer from depression, anxiety or addiction. A major study this spring found that when mothers' depression abated, their children showed improvement in their own psychiatric symptoms within three months.
The Boston Globe also gave this latest research some good coverage.
Cheers for Dr. Myrna Weissman of Columbia University's psychiatry department, who pioneered much of the research in this area, recognizing that pediatric physicians and nurses are on the front lines with postpartum women and must increase their own awareness of perinatal mood disorders as a vital part of pediatric health care. With these latest research findings, Weissman is more than ever in a position to make strong recommendations to the pediatrics community, telling The Boston Globe, "The research is so convincing, it practically screams for pediatricians to get involved in treating parents' depression."
Among the studies published in July's issue of Pediatrics:
* In a study looking at the "feasibility" of pediatricians routinely screening moms for PPD, in which rural pediatric practices used brief depression screenig of mothers at well-child visits for children of all ages (using a simple two-question patient health questionnaire): Of 1,398 mothers screened, 17% had 1 of the depressive symptoms and 6% (n = 88) scored as being at risk for a major depressive disorder. During discussion, 5.7% of all mothers thought they might be depressed and 4.7% thought they were stressed but not depressed. Pediatric clinicians intervened with 62.4% of mothers who screened positive and 38.2% of mothers with lesser symptoms. Pediatrician actions included discussion of the impact on the child, a follow-up visit or call, and referral to an adult primary care provider, a mental health clinician, or community supports. This research team concludes that "Routine, brief, maternal depression screening conducted during well-child visits is feasible and detects mothers who are willing to discuss depression and stress issues with their pediatrician. The discussion after screening reveals additional mothers who feel depressed among those with lesser symptoms.The additional discussion time was usually brief and resulted in specific pediatrician actions."
* In the study looking at when and how often pediatricians should screen for depressive symnptoms in moms, the research team used the Center for Epidemiologic Studies' Depression Scale with 3,412 mothers at 2, 4, and 30- to 33-month postpartum interviews. Among the findings: "Mothers with depressive symptoms at 2 to 4 months had reduced odds of using car seats, lowering the water heater temperature, and playing with the child at 30 to 33 months. Mothers with concurrent depressive symptoms had reduced odds of using electric outlet covers, using safety latches, talking with the child, limiting television or video watching, following daily routines, and being more nurturing. Mothers with concurrent depressive symptoms had increased odds of using harsh punishment and of slapping the child on the face or spanking with an object." Their findings and recommendations to pediatricians? "The results of our study underscore the importance of clinicians screening for maternal depressive symptoms during the toddler period, as well as the early postpartum period, because these symptoms can appear later independent of earlier screening results. Providing periodic depressive symptom screening of the mothers of young patients has the potential to improve clinician capacity to provide timely and tailored anticipatory guidance about important parenting practices, as well as to make appropriate referrals."
