This is a study to assess the impact of introducing screening and planned follow up for
postpartum depression. All women ages 18 to 45 who speak English or Spanish who come to the
enrolled community family medicine offices will either be given usual care or screened using
the Edinburgh Postnatal Depression Screening tool. If the EDPS score is high the women will
be given the PHQ-9 to more clearly identify the specific likelihood of being depressed.
Women who are determined to be depressed will be treated with medication or counseling based
on the preference of the women and their physicians. Women will be followed through nurse
initiated phone calls and visits to the physicians office.
Outcomes include the level of depression symptoms, measure of comfort with parenting, and
satisfaction with partner relationships comparing baseline levels with those at 6 and 12
months from the usual care and intervention sites. These data will be collected by
questionnaire. In addition, with the women's permission, medical records will be reviewed.
A randomized controlled trial of screening and management of postpartum depression that
includes a second phase assessing the maintenance of the intervention in the original
intervention sites and a switch from usual care to intervention in the control sites.
Planned enrollment includes 29 family medicine practices and 3000 women over a period of
four years. All follow up and management is initiated within the family medicine practices
to improve generalizability and likelihood for dissemination.
In addition to the patient centered outcomes, exploratory analyses will look at the uptake
and degree of implementation and maintenance of the intervention based on characteristics of
the practice including size, location, affiliation with larger group, type of practice and
whether or not the practice is a community health center or residency practice.
- 5 to 12 weeks postpartum
- Able to speak and read English or Spanish
- 18 to 45 years of age
- Significant cognitive impairment and unable to answer screening questions