POSTNATAL DEPRESSION IN THE COMMUNITY

Background. Postnatal depression affects 15% of all women delivered. G ood practice in antenatal and postnatal care suggests that regular con tact should take place with members of the primary health care team (P HCT) but, despite this, many cases of postnatal depression are probabl y not detected. It is also widely perceived that depressed women consu lt more frequently about themselves and their babies, but it is not cl ear whether the number of contacts with the primary health care team a s a whole reflects this. Aim. To determine whether the use of the Edin burgh Postnatal Depression Scale (EPNDS) at postnatal examination woul d detect women not recognized as depressed by the PHCT. To determine w hether the number of contacts with the PHCT could be used as a screeni ng tool for postnatal depression. Method. The EPNDS was administered a t postnatal examination to 176 women delivering their babies between 1 April 1995 and 31 October 1995. Contacts with PHCT members were recor ded up to the 42nd day after delivery, together with their assessment of the subjects' mental health. Results. Of 30 women scoring greater t han or equal to 12 on the EPNDS, only 13 were perceived to be depresse d by the PHCT. The team as a whole identified more depressed women tha n any individual professional group. There was no significant differen ce in the number of contacts made with professionals by women who were or were not depressed. Asian women were more likely to be depressed t han women from other ethnic groups. Conclusion. Despite the PHCT as a whole identifying more depressed women than any individual group, more than half were not identified by professionals. Tools such as the EPN DS should be used routinely in primary care; there is an urgent need t o validate the EPNDS for non-Caucasian women.