Screening and management of postpartum depression

Abstract

Introduction. According to statistics, postpartum depression occurs in every 7th woman. This is a current problem, which influences the mother-child relationship. Literary sources recommends screening for postpartum depression at least once in the postpartum period. Current screening tools for postpartum depression are: Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depressive Screening Scale (PDSS), Healthy Patient Scale (PQ-9). Using all those screening tools makes the detection of postpartum depression (severity, clinical manifestations and differential diagnosis) much easier and it also helps in receiving better results of the psychological and medication therapy. Aim of the study. The aim of the work is to study the assessment of specific symptoms in postpartum depression and the screening tools, as well as its management. Materials and methods. During all the process were studied literature review (20 sources, published mainly over the last 5 years), devoted to the symptoms of the postpartum depression, its classification and screening in order to detect all the symptoms of depression and start the treatment on time so as the psychotropic medications that are allowed during lactation. Results. The results of the work includes all the issues of the screening for postpartum depression, but, with a focus on the specific screening tools that are considered worldwide indicators with a fairly hight sensitivity in determining this condition. According to the literature for the Edinburgh Postpartum Depression Scale (EPDS), sensitivity is 59-100% and specificity is 49-100%, for the Postpartum Depression Screening Scale (PDSS) sensitivity and specificity are respectively: 91-94% and 72-98%, and for the Healthy Patient Scale (PQ-9), sensitivity is 75% and specificity is 90%. We also studied the clinical picture of each state in postpartum depression (ranging from milder conditions - baby blues to severe postpartum depression with a psychotic component). Management algorithms were also examined for each state of postpartum depression (psychotherapy and drug treatment, taking into account medications that are allowed during lactation according to the recommendations of the FDA). Conclusions. In this work are listed the screening tools for postpartum depression, the examination of the clinical picture for each state of postpartum depression, and management algorithms for postpartum depression. We gave a special attention to the management and all possible issues of drug and non-drug treatment.