Long-term outcomes of participants in a perinatal depression early detection program

• Published in: Journal of affective disorders Vol. 129; no. 1; pp. 94 - 103
• Main Authors: Reay, Rebecca, Matthey, Stephen, Ellwood, David, Scott, Maureen
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.03.2011; Elsevier
• Subjects: Adaptation, Psychological; Adult; Adult and adolescent clinical studies; Affect; Biological and medical sciences; Bonding; Data Collection; Depression; Depression, Postpartum - diagnosis; Depression, Postpartum - psychology; Depression, Postpartum - therapy; Early Diagnosis; Early warnings; Female; Follow-Up Studies; Health Services Accessibility; Humans; Interpersonal Relations; Mass Screening; Maternal bonding; Medical sciences; Mood disorders; Mother-Child Relations; Mothers; Partner; Perinatal; Postnatal depression; Postpartum; Postpartum women; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Screening; Symptoms; Treatment Outcome; Young Adult; Perinatal; Screening; Postnatal depression; Maternal bonding; Partner; Postpartum; Mood disorder; Depression; Medical screening; Maternal diseases; Puerperium; Long term; Evolution; Early
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2010.07.035

Abstract Background Long-term follow-up studies are required to better understand the extent of the effectiveness of early detection programs for perinatal depression. We followed up participants in such a program to investigate the long-term depression, treatment and relationship outcomes of mothers originally identified as ‘probably depressed’ (screened positive). Methods At 2 years postpartum all participants who had ‘screened positive’ (N = 159) and a random sample of participants who had ‘screened negative’ were invited to participate in a mailed survey. Measures included: current mood; coping; access to treatment; quality of partner relationship; and mother–infant bonding. Results Mothers originally detected as probably depressed (n = 98) fared significantly worse than ‘screened negative’ mothers (n = 101) both in terms of their higher mean depression scores (EPDS: Ms = 11.0 vs. 6.4) and greater proportions categorised as probably depressed at 2 years postpartum (40% vs. 11% respectively, p < .001, phi = .33). Elevated depression symptoms at 2 years postpartum were associated with poorer partner relationships and mother–infant bonding. Moreover, there appears to be a double dose effect for women who screen positive on two occasions. Thirty-seven percent of depressed mothers did not take up treatment, frequently citing a preference for using their own resources. Limitations Limitations include the use of self-report measures to assess depression symptoms and mother–infant bonding. Treatment data was collected retrospectively. Conclusions Despite being offered treatment options, a substantial proportion of women who screened positive had poor long-term mental health and relationship outcomes. This paper discusses some of the implications for perinatal early detection and treatment programs.