Population-based screening for postpartum depression

Objective: To estimate the community prevalence in Olmsted County, Minnesot a of elevated scores on the Edinburgh Postnatal Depression Scale, a self-re port screening tool for postpartum depression. Methods: At the 6-week postpartum visit, the Edinburgh Postnatal Depression Scale was administered to women who gave birth in Olmsted County between J uly 28, 1997 and March 28, 1998. Study sites included all ambulatory clinic s that provide pregnancy care in the county, and women who missed postpartu m visits were contacted by mail. A threshold of 12 or more points on the sc ale was selected for clinical use; data for scores of ten and above were al so examined. Results: Of the 909 Olmsted County women studied (response rate 83.2%), 11. 4% (n = 104) had scores of 12 or greater, with a 95% confidence interval (C I) of 9.4%, 13.5%. The percentage of women with a positive screen increased to 19.8% (rr = 180; 95%, CI 17.2%, 22.4%) when scores of 10 or higher were included, as has been recommended for screening in primary care settings. Forty-eight or 5.3% of the subjects (95% CI 3.8%, 6.7%) indicated experienc ing suicidal ideation during the previous week. Conclusion: More than 11% of women had elevated scores on the Edinburgh Pos tnatal Depression Scale, indicating a high likelihood of postpartum depress ion and the need for further assessment. The screening process required lit tle extra time and was acceptable to the subjects and clinicians. Screening for postpartum depression is appropriate and feasible for clinical practic e and increases the identification of women suffering from this serious, co mmon, and highly treatable disorder. (C) 1994 by The American College of Ob stetricians and Gynecologists.