Regular enquiry about well-being rather than universal screening to detect depression in pregnancy and after birth
New guideline
How do you detect depression in pregnant and postpartum patients? Rather than using a screening tool and cutoff score with all pregnant and postpartum patients, clinicians should ask about well-being as part of usual care, recommends a new guideline from the Canadian Task Force on Preventive Health Care.
Aimed at primary care providers, the guideline applies to pregnant and post-partum people in the first year after delivery.
“Depression in pregnant and postpartum people is devastating, with a massive burden for families and it’s critical to detect it,”
The guideline, published in CMAJ, is based on a rigorous systematic review of latest evidence that found no benefit of routine screening as well as patient values and preferences.
Who is exempt from this recommendation?
- Pregnant or postpartum people with a history of depression or who are being assessed or treated for other mental disorders.
Putting into Practice
Clinicians should
- Ask patients how they are feeling and about their well-being during visits
- Remain vigilant for depression
- Practice clinical judgment to determine if patients require additional follow-up
Recommendation on instrument-based screening for depression during pregnancy and the postpartum period was published in CMAJ on July 25, 2022.
Depression resources
- The Canada Suicide Prevention Service
- Quebec: 1.866.277.3553
- Postpartum Support International
- Your Life Counts
Endorsement
The College of Family Physicians of Canada has endorsed the guideline.
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