Researchers call for screening moms for depression before, during, and after pregnancy

Untreated depression during or after pregnancy has negative consequences for the mother and child. The most common pregnancy complication, and the leading cause of preventable maternal mortality, are perinatal mental health problems. Sometimes, clinicians don't want to screen for something because they don't know what to do if the results are positive; but in the case of perinatal depression, there are treatments, according to a new study. New screening recommendations for perinatal depression call for multiple screenings. New, rapidly acting treatment for depression onset in late pregnancy and early postpartum benefit both mother and child. Two-thirds of moms with perinatal depression have one or more psychiatric conditions. Eighty-three percent have anxiety disorders as well as depression. More than 75% of moms who screen positive for perinatal depression receive no treatment at all. Screening tools are not diagnostic, and there could be false positives. To fully assess depression, clinicians need to go beyond the screening tool, to query symptom type, frequency, severity, and duration, as well as how symptoms affect daily functioning, the researchers write. Before treating the patient with pharmacotherapy, clinicians should consider bipolar disorder, which is treated with mood stabilizers rather than antidepressants. Treating bipolar disorder with antidepressants can precipitate mania or psychosis, the researchers write, adding that this can increase the risk of suicide or infanticide. First-line treatment for mild depression is psychotherapy, but regardless of symptom severity, all patients with depression should be referred to psychotherapy. (Also see lead story, this issue, page 1.) Moore Simas, et al. (2023, Dec 19). Postpartum depression: New screening recommendations and treatments. JAMA, 330(23), 2295–2296. http://doi.org/10.1001/jama.2023.21311. Email: [email protected].