Materiały źródłowe

• #1 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  Perinatal depression is a prevalent and potentially severe mood disorder that affects approximately 1 in 7 people during pregnancy or within the first year after childbirth. […] Effective recognition and management of perinatal depression are essential for optimizing the health outcomes of the parent and infant. […] Screening for perinatal depression using tools like the Edinburgh Postnatal Depression Scale (EPDS) is crucial for early diagnosis. […] Treatment typically involves psychotherapy, support groups, and medications such as antidepressants, which are generally safe during pregnancy and lactation. […] Perinatal depression is diagnosed when at least 5 depressive symptoms are present for at least 2 weeks. […] The following 9 symptoms in affected people may be present almost daily and represent a change from the previous routine; however, a perinatal depression diagnosis should always include either depression or anhedonia: Depressed mood (subjective or observed) is present most of the day, Loss of interest or pleasure (anhedonia), most of the day, Sleep disturbances (insomnia or hypersomnia), Psychomotor retardation or agitation, Worthlessness or guilt, Loss of energy or fatigue, Suicidal ideation or attempt and recurrent thoughts of death, Impaired concentration or indecisiveness, Change in weight or appetite (eg, a weight change of 5% over 1 month).

• #1 Postpartum Depression Statistics | Research and Data On PPD (2024)

  https://www.postpartumdepression.org/resources/statistics/

  Postpartum depression is a condition that takes many forms and can remain undiagnosed for long periods of time. […] It is estimated that nearly 50% of mothers with postpartum depression are not diagnosed by a health professional. […] The overall success rate for treating postpartum depression is 80%, making it essential for anyone who wants to heal. […] As with all forms of mental illnesses, early recognition and treatment of postpartum depression can lead to better symptom management and faster recovery rates. […] Consult with your doctor immediately if you’re experiencing symptoms of postpartum depression.

• #1 Postnatal depression – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/512

  Postnatal depression may present with symptoms of depressed mood, anhedonia, weight changes, sleep disturbance, psychomotor problems, low energy, excessive guilt, loss of confidence or self-esteem, poor concentration, or suicidal ideation. […] Recognition and effective treatment is vital; untreated postnatal depression causes substantial impairment for the woman, and may also result in impaired behavioural, emotional, and cognitive outcomes for the baby. […] Exclude postnatal psychosis and bipolar disorder in all patients. […] Treatment is with psychological therapy and/or medication. Antidepressants are recommended for more severe episodes if the woman declines psychological therapy or if psychological therapy is either ineffective or unavailable. […] Psychiatric referral may be necessary for patients who do not respond to treatment. Urgent psychiatric assessment is warranted if there is a risk of self-harm or harm to the child at any time, or if a postnatal psychosis, or manic or mixed episode, is suspected.

• #1 Postnatal depression – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/512

  Episodes of postnatal depression last 3 to 6 months on average, but may last for months or even years. […] Postnatal depression refers to the development of a depressive illness following childbirth and may form part of a bipolar or, more usually, a unipolar illness. […] The onset of a depressive episode within 4 weeks of childbirth can be recorded via the peripartum-onset specifier in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR). […] Symptom onset in pregnancy (and before pregnancy) is not uncommon; therefore, the term perinatal depression may be strictly more accurate. […] Key diagnostic factors include presence of risk factors, depressed mood, anhedonia, decreased energy or increased fatigability, suicidal ideation, loss of confidence or self-esteem, unreasonable feelings of self-reproach or excessive and inappropriate guilt, and poor concentration.

• #1 Postnatal Depression: Causes and Treatment | Doctor

  https://patient.info/doctor/postnatal-depression-pro

  Postnatal depression (PND) refers to the development of a depressive illness following childbirth and may form part of a bipolar or, more usually, a unipolar illness. […] PND is not recognised by the DSM-V current classification systems as a condition in its own right, but the onset of a depressive episode within four weeks of childbirth can be recorded via the perinatal-onset specifier in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). It is recognised in the ICD-11 classification, more commonly used in the UK. […] There is evidence to suggest that the DSM-5 specifier is too narrow; therefore, most clinicians, and the National Institute for Health and Care Excellence (NICE), consider depressive episodes occurring within 12 months of delivery to be PND.

• #1 Postpartum depression – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/512

  Other diagnostic factors include change in psychomotor activity, sleep disturbance, change in appetite, change in weight, obsessive/intrusive thoughts, significant self-harm or neglect or mistreatment of children, personal or family history of hypomania or mania, and psychotic symptoms. […] 1st tests to order include Depression identification questions, Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), and Mood Disorder Questionnaire (MDQ).

• #1 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), and the American Academy of Family Medicine (AAFP) all recommend screening every patient for perinatal depression using the EPDS. […] Several screening tools are available, including the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Scale (GAD-7). […] The first-line treatment for perinatal depression is psychotherapy and antidepressant medications. […] A combination of therapy and antidepressant medications is recommended for moderate to severe depression. […] The goal of treatment for perinatal depression is remission or resolution of symptoms of depression. […] Once an effective dose is reached, continued treatment for at least 6 to 12 months is recommended to prevent relapse of symptoms.

• #1 The Identification of Postpartum Depression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2736559/

  The most common measure to screen for depression related to childbearing is the EPDS. This self-report instrument contains ten items ranked from 0 to 3 that reflect the patients experience over the past week. […] An EPDS 13 is an acceptable cut-point for identifying women at risk for major depression in clinical settings. […] The optimal time to screen for PPD is at the first postnatal obstetrical visit, since extensive data suggest the onset of postpartum disorders occur within the first month of childbirth. […] Patients with EPDS 13 are at substantial risk for major depression and require prompt depression care and treatment planning. […] Routine depression screening in OB settings is an efficient and feasible method to improve the identification of postpartum depressed patients with minimal risk for harm. […] The EPDS is an acceptable instrument for routine screening. The recommended cut-point is an EPDS 13; the optimal time to screen for depression is 4-6 weeks after delivery.

• #1 Using the EPDS as a screening tool – COPE

  https://www.cope.org.au/health-professionals/health-professionals-3/calculating-score-epds/

  The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire originally developed to assist in identifying possible symptoms of depression in the postnatal period. […] The EPDS is not a diagnostic tool. Rather, it is a screening tool that aims to identify women who may benefit from follow-up care, such as mental health assessment, which may lead to a diagnosis based on accepted diagnostic criteria (DSM-IV-TR or ICD-10). […] Clinical judgement is integral to interpreting EPDS scores, as in some cases the score may not accurately represent a woman’s mental health. […] A total score of 13 or more is considered a flag for the need for follow up of possible depressive symptoms. […] Follow-up may also be needed if scores on Questions 3, 4 and 5 suggest possible symptoms of anxiety. […] For scores of 1, 2 or 3 on Question 10, the safety of the woman and children in her care should be assessed and, according to clinical judgment, advice sought and/or mental health assessment arranged.

• #1 Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care

  https://www.mdpi.com/2075-4418/14/9/865

  Patients with risk factors should be screened with the Edinburgh Postnatal Depression Scale (EPDS). […] The Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Depression Screening Scale (PDSS) are used specifically for the diagnosis of postnatal depression, while the Patient Health Questionnaire (PHQ-9) is recommended for the diagnosis of depression in psychiatric medical institutions. […] Obstetricians should include brief screening methods for PPD in the evaluation of pregnant women during their visits. Thus, if PPD is diagnosed, patients should be informed about all therapeutic techniques.

• #1 Postpartum depression | March of Dimes

  https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-depression

  Postpartum depression (also called PPD) is not your fault. Its a medical condition that needs treatment to get better. […] If you have signs or symptoms of PPD, talk to your provider about treatment. […] PPD is a kind of perinatal depression. This is depression that happens during pregnancy or in the first year after giving birth. […] If you think you have signs or symptoms of PPD, call your health care provider right away. […] Your health care provider screens (checks) you for PPD at your postpartum care checkups. Screening means that your provider asks you questions about your risks, feelings and mood. If the screening shows that you may have PPD or that you’re at risk for PPD, your provider can help you get treatment. […] The U.S. Preventive Services Task Force says that certain kinds of counseling (also called therapy) can prevent perinatal depression (including PPD) for women at increased risk of depression.

• #1 Patient Screening | ACOG

  https://www.acog.org/programs/perinatal-mental-health/patient-screening

  ACOGs Clinical Practice Guideline 4: Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum recommends that: […] Everyone receiving well-woman, prepregnancy, prenatal, and postpartum care be screened for depression and anxiety using standardized, validated instruments […] Screening for perinatal depression and anxiety occur at the initial prenatal visit, later in pregnancy, and at postpartum visits […] Mental health screening be implemented with systems in place to ensure timely access to assessment and diagnosis, effective treatment, and appropriate monitoring and follow-up, based on severity […] ACOG recommends that screening for perinatal depression and anxiety occur at the initial prenatal visit, later in pregnancy, and at postpartum visits using a standardized, validated instrument.

• #1 Postpartum Depression: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression

  Postpartum depression can last until one year after your child is born. […] Talk to your healthcare provider about your symptoms and treatment. […] Contact your healthcare provider if you think you have postpartum depression. […] There isn’t a specific test that diagnoses postpartum depression. Your healthcare provider will evaluate you at your postpartum visit. […] Many providers schedule visits at two or three weeks postpartum to screen for depression. […] They may do a depression screening or ask you a series of questions to assess if you have postpartum depression. […] If your provider feels you have signs of postpartum depression, they will recommend an appropriate treatment. […] Postpartum depression is treated differently depending on the type and severity of your symptoms.

• #1 Timing of Postpartum Depressive Symptoms

  https://www.cdc.gov/pcd/issues/2023/23_0107.htm

  Postpartum depression is common and can last long-term. Few studies have examined depressive symptoms late (9-10 months) in the postpartum period. […] We found 7.2% of postpartum women had depressive symptoms at 9 to 10 months after giving birth, 57.4% of whom did not have postpartum depressive symptoms at 2 to 6 months after giving birth. About 3.1% had symptoms of depression at both times. […] Screening for depression throughout the first postpartum year can identify women who are not symptomatic early postpartum but later develop symptoms. […] Postpartum depression is a serious public health problem that can adversely impact mother-child interactions. […] Nearly 3 in 5 women with PDS at 9 to 10 months did not report PDS at 2 to 6 months. […] Screening for depression throughout the first postpartum year can identify women who are not symptomatic early in the postpartum period but later develop symptoms.

• #1 Postpartum Depression Diagnosis – How To Get an Accurate PPD Diagnois

  https://www.postpartumdepression.org/postpartum-depression/diagnosis/

  If you suspect that you are experiencing symptoms of postpartum depression, getting an official diagnosis can help you progress with the proper treatment. A diagnosis can help you feel better and also assist you and your family members better understand and cope with your current condition. […] There is no single diagnostic tool or test that physicians use to reach a postpartum depression diagnosis. […] Instead, doctors will diagnose a mother with PPD by: Assessing her signs and symptoms, Interviewing the mother, Performing initial psychological screenings, Testing for other medical conditions or health problems. […] In addition to the diagnostic process used by the family doctor, new mothers can seek the support of a mental health professional. They can conduct a psychological assessment and reach a diagnosis.

• #1 Do I have Postpartum Depression? Postnatal Depression Test

  https://damorementalhealth.com/postpartum-depression-test/

  Do I have Postpartum Depression? Our Online Postnatal Depression Test to learn more about the Symptoms of PPD. […] Unfortunately, there are no definitive lab tests or imaging that diagnose depression consistently. Instead, your physician or a psychiatrist will assess your symptoms and make a diagnosis. […] A postpartum depression diagnosis goes far beyond baby blues and can affect approximately 15% of new mothers. […] What are some of the signs you have postpartum depression? Psychiatrists use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The major depressive episode should onset within four weeks after delivery. […] Additionally, symptoms must be present for at least two weeks, and a patient should present with at least five of the following: Depressed mood, Loss of interest in activities or hobbies, Sleep impairment, Worthlessness, Fatigue, Difficulty concentrating, Suicide ideation, Weight change.

• #1 Postpartum depression – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623

  Your health care provider will usually talk with you about your feelings, thoughts and mental health to help determine if you have a short-term case of postpartum baby blues or a more severe form of depression. […] As part of your evaluation, your health care provider may do a depression screening, including having you fill out a questionnaire. Your provider may order other tests, if needed, to rule out other causes for your symptoms. […] Postpartum depression is often treated with psychotherapy also called talk therapy or mental health counseling medicine or both. […] Your health care provider may recommend an antidepressant. […] Brexanolone (Zulresso) is the first drug approved by the U.S. Food and Drug Administration specifically for postpartum depression in adult women. […] With appropriate treatment, postpartum depression symptoms usually improve.

• #1 Postpartum depression – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623

  It’s important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse. […] So, if you’re having trouble coping with postpartum depression, talk with your health care provider. […] Your health care provider or mental health provider may ask you some questions, such as: What are your symptoms, and when did they start? […] Your provider may ask additional questions based on your responses, symptoms and needs. Preparing for questions will help you make the most of your appointment.

• #1 Postpartum Major Depression | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1015/p926.html

  The diagnosis of postpartum major depression should also include asking patients about past manic episodes. […] Because hypothyroidism may also cause depressive symptoms, physicians should measure thyroid-stimulating hormone levels in women with suspected postpartum major depression. […] The Edinburgh Postnatal Depression Scale can be used to monitor progress over time.

• #1 Postpartum Depression Diagnosis – How To Get an Accurate PPD Diagnois

  https://www.postpartumdepression.org/postpartum-depression/diagnosis/

  The first critical step in reaching a postpartum depression diagnosis is taking note of the initial signs and symptoms that you experience. […] If the questionnaire or screening test results point to known signs and symptoms of postpartum depression, a doctor may reach a diagnosis at this stage. […] If a patient’s symptoms align with postpartum depression, a mental health professional can use the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). […] A postpartum depression diagnosis reached using the DSM-5 also helps families. With a medically backed diagnosis, insurance providers will reimburse families for their medical expenses. […] After you have been officially diagnosed with PPD, you and your doctor can decide on a course of action and depression treatment for you.

• #1 Patient Screening | ACOG

  https://www.acog.org/programs/perinatal-mental-health/patient-screening

  After a woman completes the screening tools, they should be scored by clinical staff, entered into the chart, and included in an electronic medical record. […] It is imperative that they are scored before a woman leaves her appointment, so that a positive screen can be promptly addressed. […] You may consider screening all women for bipolar disorder. Minimally it needs to be done prior to initiating an antidepressant because 1 in 5 women who screen positive for depression may have bipolar disorder. […] Treatment of bipolar disorder with an antidepressant alone is contraindicated and is associated with worsening of mood symptoms which can increase risk of mania, psychosis, and suicide. […] In general, if bipolar disorder is suspected, consultation with or referral to psychiatry for further assessment is indicated.

• #1 Postpartum Psychiatric Disorders – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders-2/

  Initial evaluation should include a thorough history, physical examination, and routine laboratory tests. […] Non-pharmacological therapies are useful in the treatment of postpartum depression. […] To date, only a few studies have systematically assessed the pharmacological treatment of postpartum depression. […] Given the prevalence of anxiety symptoms in this population, adjunctive use of a benzodiazepine (e.g., clonazepam, lorazepam) may be very helpful. […] Puerperal psychosis is considered a psychiatric emergency that typically requires inpatient treatment. Acute treatment with either typical or atypical anti-psychotic medications is indicated. […] For women with histories of postpartum depression, several studies have described a beneficial effect of prophylactic antidepressant (either TCAs or SSRIs) administered after delivery.

• #1 Psychiatry.org – What is Perinatal Depression (formerly Postpartum)?

  https://www.psychiatry.org/patients-families/peripartum-depression/what-is-peripartum-depression

  While there is no specific diagnostic test for perinatal depression, it is a clinical medical condition that is diagnosed by medical professionals. It is a real illness that should be taken seriously. Any pregnant person or new parent who experiences the symptoms of perinatal depression should seek evaluation by a medical professional a family medicine doctor or an OB-GYN who can make referrals to a psychiatrist or other mental health professional. […] Assessment should include a psychiatric evaluation and a medical evaluation to rule out physical problems that may have symptoms similar to depression (such as thyroid problems or vitamin deficiencies).

• #1 Early identification of postpartum depression using demographic, clinical, and digital phenotyping | Translational Psychiatry

  https://www.nature.com/articles/s41398-021-01245-6

  Postpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention. Combinations of anamnestic, clinical, and remote assessments were evaluated for an early and accurate identification of PPD and AD. […] Early diagnosis and treatment of PPD can substantially improve the outcome, prevent relapse, and minimize the associated emotional and financial burden. […] PPD is often overlooked during postnatal visits, missing the critical window for early intervention. […] History of mental illness, vulnerability to hormonal changes, psychological and social distress, baby blues, premenstrual syndrome (PMS), unwanted pregnancy, traumatic birth experience and stressful life events are all associated with an increased risk of PPD.

• #1 Postnatal Depression: Causes and Treatment | Doctor

  https://patient.info/doctor/postnatal-depression-pro

  At booking and at postnatal checks, all health professionals should consider mental health screening questions. […] If the answer is „yes” to any of these questions, or if there is clinical concern, further assessment is required. This may be by the use of a formal assessment tool, such as the Patient Health Questionnaire (PHQ-9), the Edinburgh Postnatal Depression Scale or the Generalised Anxiety Disorder Scale (GAD-7). […] NICE advises that assessment of any mental health problem in either pregnancy or the postnatal period should include the following: Past history or family history of any mental health problem. Also any current or past treatment for a mental health problem and response to any treatment. […] Women should be proactively screened for mental health problems, and high-risk patients identified. It is advised that when women present for booking and at the postnatal check, health professionals (including midwives, obstetricians, health visitors and GPs) should ask questions to screen for depression and anxiety.

• #1 2025 ICD-10-CM Diagnosis Code F53.0: Postpartum depression

  https://www.icd10data.com/ICD10CM/Codes/F01-F99/F50-F59/F53-/F53.0

  F53.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. […] F53.0 is applicable to maternity patients aged 12 – 55 years inclusive. […] F53.0 is applicable to female patients. […] Applicable To: Postnatal depression, NOS. […] Diagnosis Index entries containing back-references to F53.0: postnatal F53.0 (NOS). […] Type 1 Excludes: puerperal F53.0.

• #1 Postpartum depression – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

  Postpartum depression may be mistaken for baby blues at first but the symptoms are more intense and last longer. […] If you experience any symptoms of postpartum baby blues or postpartum depression, call your primary health care provider or your obstetrician or gynecologist and schedule an appointment. […] If you have a history of postpartum depression, your provider may recommend antidepressant treatment or talk therapy immediately after delivery. Most antidepressants are safe to take while breastfeeding.

• #1

  https://journals.lww.com/jaapa/fulltext/2013/02000/postpartum_depression__symptoms,_diagnosis,_and.9.aspx

  Recent expert opinions suggest that onset within the first 3 months is a more clinically accurate criterion, and that symptom onset of PPD may occur at any point within the first 12 months after childbirth. […] A detailed history is crucial to carefully differentiate between PPD and a normal postpartum course.

• #1 Postnatal depression – NHS

  https://www.nhs.uk/mental-health/conditions/post-natal-depression/overview/

  The mental health team, maternity team and GP will work closely with you during your pregnancy and after you have given birth. […] Postnatal depression is often misunderstood and there are many myths surrounding it. […] Unlike the „baby blues”, postnatal depression can persist for months if left untreated and in a minority of cases it can become a long-term problem.

• #1 Postpartum Depression: Treatment and Diagnosis | Psych Central

  https://psychcentral.com/depression/postpartum-depression-treatment

  Postpartum depression is depression during pregnancy and after childbirth that can last for months or longer. […] The most widely used method to assess for PPD is the Edinburgh Postnatal Depression Scale (EPDS), which consists of 10 questions that prompt people to score how they are feeling. […] Postpartum depression is already underdiagnosed, but there is even more of a disparity in women of color, says Kukla. […] According to one study, women of color and those with low socioeconomic status are at increased risk of prenatal (before delivery) and postpartum (after delivery) depressive symptoms. […] The American Psychiatric Association recommends psychotherapy without medication for pregnant people or those who are breastfeeding who have major depressive disorder if they are experiencing mild anxiety or depression.

• #1 Timing of Postpartum Depressive Symptoms

  https://www.cdc.gov/pcd/issues/2023/23_0107.htm

  Our findings, that more than half of women with PDS at 9 to 10 months did not report symptoms earlier in the postpartum period and that 3 in 5 women with PDS at 9 to 10 months had comorbid anxiety symptoms, underscore the importance of screening for depression, anxiety, and substance use throughout the perinatal period.

• #1 Identification and Management of Peripartum Depression | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0515/p852.html/1000

  Both one-step and two-step screening strategies are effective in identifying peripartum depression. […] A statement from the U.S. Preventive Services Task Force recommends screening adults 18 years and older, including pregnant and postpartum women, for depression, with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. […] When peripartum depression is suspected, a stepwise approach should be taken initially. […] Patients with active suicidal thoughts, thoughts of harming their newborns, or psychosis should have same-day psychiatric consultation for possible inpatient treatment.

• #2 Postpartum Depression: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression

  Postpartum depression is a type of depression that happens after having a baby. It affects up to 15% of women. Postpartum depression can be treated with medication and counseling. […] Postpartum depression (PPD) is a type of depression that happens after you give birth. […] If you have postpartum depression, know that you’re not alone. It’s not your fault. And that help is out there. Your healthcare provider can manage your symptoms and help you feel better. […] Postpartum depression is a far more serious condition than the baby blues, affecting about 1 in 7 new moms. […] Symptoms range from mild to severe and may appear within a week of delivery or gradually, even up to a year later. […] Although symptoms can last several months, treatment with psychotherapy or antidepressants is very effective.

• #2 New postpartum depression drugs are here. Diagnosis, treatment hurdles still stand in the way. | BioPharma Dive

  https://www.biopharmadive.com/news/postpartum-depression-drugs-access-hurdles-treatment-zurzuvae-zulresso/712747/

  According to the Centers for Disease Control and Prevention, approximately 60% of women with symptoms of postpartum depression go undiagnosed, and half of those diagnosed aren’t treated. […] The drawn-out recognition of PPD left women dealing with the condition to fend for themselves for decades. […] The U.S. Preventative Services Task Force and American Psychological Association soon followed with similar recommendations. […] Historically, the messaging was that pregnancy is the greatest time in a woman’s life, and there’s no happier time than after a baby’s delivered. […] The fact that this medication works quickly, and also gives [patients] that added relief for sleep and anxiety is beneficial compared to an SSRI that works slower, and may not necessarily relieve sleep and anxiety as rapidly.

• #2 Postpartum depression – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/512

  Postpartum depression may present with symptoms of depressed mood, anhedonia, weight changes, sleep disturbance, psychomotor problems, low energy, excessive guilt, loss of confidence or self-esteem, poor concentration, or suicidal ideation. […] Recognition and effective treatment is vital; untreated postpartum depression causes substantial impairment for the woman, and may also result in impaired behavioral, emotional, and cognitive outcomes for the baby. […] Exclude postpartum psychosis and bipolar disorder in all patients. […] Treatment is with psychological therapy and/or medication. Antidepressants are recommended for more severe episodes if the woman declines psychological therapy or if psychological therapy is either ineffective or unavailable. […] Psychiatric referral may be necessary for patients who do not respond to treatment. Urgent psychiatric assessment is warranted if there is a risk of self-harm or harm to the child at any time, or if a postpartum psychosis, or manic or mixed episode, is suspected.

• #2 Postpartum depression – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/512

  Episodes of postpartum depression last 3 to 6 months on average, but may last for months or even years. […] Postpartum depression refers to the development of a depressive illness following childbirth and may form part of a bipolar or, more usually, a unipolar illness. […] The onset of a depressive episode within 4 weeks of childbirth can be recorded via the peripartum-onset specifier in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR). […] Symptom onset in pregnancy (and before pregnancy) is not uncommon; therefore, the term „perinatal depression” may be strictly more accurate. […] Key diagnostic factors include depressed mood, anhedonia, decreased energy or increased fatigability, suicidal ideation, loss of confidence or self-esteem, unreasonable feelings of self-reproach or excessive and inappropriate guilt, and poor concentration.

• #2

  https://journals.lww.com/jaapa/fulltext/2013/02000/postpartum_depression__symptoms,_diagnosis,_and.9.aspx

  Recent expert opinions suggest that onset within the first 3 months is a more clinically accurate criterion, and that symptom onset of PPD may occur at any point within the first 12 months after childbirth. […] A detailed history is crucial to carefully differentiate between PPD and a normal postpartum course.

• #2 Diagnosis and Management of Postpartum Depression

  http://www.fortunejournals.com/articles/diagnosis-and-management-of-postpartum-depression.html

  Postpartum Depression (PPD) is a severe mental health problem that affects up to 15% of mothers. […] The obstetrician, pediatrician and primary health care physicians have a crucial role in screening for and treating PPD. […] This review aims to provide a holistic approach for PPD diagnosis and management. […] The clinical features of postpartum major depression appear comparable to those of major depressive episodes that occur outside of the postpartum period. […] Postpartum depression is diagnosed when at least five depressive symptoms are present for at least two weeks. […] The diagnosis should include depression or anhedonia (loss of interest) and five symptoms. […] Screening for PPD can be done 2 to 6 months after childbirth. […] Based upon practice guidelines issued by the United States Preventive Services Task Force, primary care clinicians (including obstetricians, gynaecologists, or pediatricians) should screen all postpartum women for depression.

• #2 The Identification of Postpartum Depression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2736559/

  Postpartum depression (PPD) is the most common medical complication of childbearing. Universal screening maximizes the likelihood of prompt identification of PPD. […] In this paper, we review the diagnostic criteria for postpartum depressive disorders and clinical risk factors predictive of PPD. […] We examine depression screening tools, appropriate cut-points associated with positive screens, the optimal timing for screening and the acceptability of depression screening in obstetrical settings. […] In the Diagnostic and Statistical Manual (DSM-IV), an episode of major depression after delivery is defined as two weeks or more of persistent: 1) depressed mood, or 2) loss of interest in daily activities plus four associated symptoms (appetite disturbance, sleep disturbance, psychomotor agitation or slowing, fatigue, feelings of worthlessness or inappropriate guilt, poor concentration, suicidal ideation) that onset within 4 weeks after childbirth.

• #2 Identification and Management of Peripartum Depression | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0515/p852.html/1000

  Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. […] The U.S. Preventive Services Task Force recommends screening pregnant and postpartum women for depression. […] Both two-step and one-step screening strategies are effective in identifying peripartum depression. […] Women with peripartum depression should be evaluated for bipolar disorder, postpartum psychosis, and suicidal risk. […] The Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) classifies peripartum depression as a major depressive disorder that is identified during pregnancy or within four weeks postpartum. […] Because many symptoms of major depressive disorder are not specific for peripartum depression, validated screening tests should be used to evaluate pregnant women.

• #2 SciELO Brasil – Screening and diagnosing postpartum depression: when and how? Screening and diagnosing postpartum depression: when and how?

  https://www.scielo.br/j/trends/a/bYZYqjFz3zbW4YhfshwLy3s/

  The Edinburgh Postnatal Depression Scale (EPDS) was the most common screening tool, used in 68% of the sample (15 articles), followed by the Beck Depression Inventory (BDI-II) (27%, 6 articles), and the Patient Health Questionnaire-9 (PHQ-9) (18%, 4 articles). […] The most frequent PPD diagnosis tool was the EPDS, but other scales were also used. The most common period for diagnosis was up to 3 months postpartum. However, some researchers diagnosed PPD 12 months or more postpartum. […] There is also no consensus on the ideal time to conduct screening, whether it is only possible to diagnose PPD during the puerperal period, or on how soon after a delivery depression may be related to it. […] It is necessary to define the most appropriate time and method for detecting PPD, so interventions to reduce this condition’s impact on maternal and child health can be developed.

• #2 Using the EPDS as a screening tool – COPE

  https://www.cope.org.au/health-professionals/health-professionals-3/calculating-score-epds/

  The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire originally developed to assist in identifying possible symptoms of depression in the postnatal period. […] The EPDS is not a diagnostic tool. Rather, it is a screening tool that aims to identify women who may benefit from follow-up care, such as mental health assessment, which may lead to a diagnosis based on accepted diagnostic criteria (DSM-IV-TR or ICD-10). […] Clinical judgement is integral to interpreting EPDS scores, as in some cases the score may not accurately represent a woman’s mental health. […] A total score of 13 or more is considered a flag for the need for follow up of possible depressive symptoms. […] Follow-up may also be needed if scores on Questions 3, 4 and 5 suggest possible symptoms of anxiety. […] For scores of 1, 2 or 3 on Question 10, the safety of the woman and children in her care should be assessed and, according to clinical judgment, advice sought and/or mental health assessment arranged.

• #2 Postpartum Psychiatric Disorders – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders-2/

  Postpartum depression is clinically indistinguishable from depression occurring at other times during a woman’s life. The symptoms of postpartum depression include: Depressed or sad mood, Tearfulness, Loss of interest in usual activities, Feelings of guilt, Feelings of worthlessness or incompetence, Fatigue, Sleep disturbance, Change in appetite, Poor concentration, Suicidal thoughts. […] The Edinburgh Postnatal Depression Scale is a 10-item questionnaire that may be used to identify women who have PPD. On this scale, a score of 12 or greater or an affirmative answer on question 10 (presence of suicidal thoughts) raise concern and indicate a need for more thorough evaluation. […] Given the potential adverse effects of untreated mood and anxiety symptoms on both the mother and child, careful screening and early recognition of anxiety symptoms during the postpartum period is recommended.

• #2 Postpartum depression – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/512

  Other diagnostic factors include change in psychomotor activity, sleep disturbance, change in appetite, change in weight, obsessive/intrusive thoughts, significant self-harm or neglect or mistreatment of children, personal or family history of hypomania or mania, and psychotic symptoms. […] 1st tests to order include Depression identification questions, Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), and Mood Disorder Questionnaire (MDQ).

• #2 Patient Screening | ACOG

  https://www.acog.org/programs/perinatal-mental-health/patient-screening

  ACOGs Clinical Practice Guideline 4: Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum recommends that: […] Everyone receiving well-woman, prepregnancy, prenatal, and postpartum care be screened for depression and anxiety using standardized, validated instruments […] Screening for perinatal depression and anxiety occur at the initial prenatal visit, later in pregnancy, and at postpartum visits […] Mental health screening be implemented with systems in place to ensure timely access to assessment and diagnosis, effective treatment, and appropriate monitoring and follow-up, based on severity […] ACOG recommends that screening for perinatal depression and anxiety occur at the initial prenatal visit, later in pregnancy, and at postpartum visits using a standardized, validated instrument.

• #2 Timing of Postpartum Depressive Symptoms

  https://www.cdc.gov/pcd/issues/2023/23_0107.htm

  Our findings, that more than half of women with PDS at 9 to 10 months did not report symptoms earlier in the postpartum period and that 3 in 5 women with PDS at 9 to 10 months had comorbid anxiety symptoms, underscore the importance of screening for depression, anxiety, and substance use throughout the perinatal period.

• #2 Diagnosis of Postnatal Depression | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/diseases/postnatal-depression/diagnosis

  The diagnosis of postnatal depression is made by means of a clinical interview with the patient. There are no imaging or laboratory tests that can help to provide a reliable diagnosis of the disorder. […] For the detection of postnatal depression questionnaires, such as the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987; validated by Garcia-Esteve et al., 2003) can be used. When elevated scores in this scale are obtained, specialists in psychiatry or psychology are required in order to confirm the diagnosis by means of a clinical interview.

• #2 Postpartum depression – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623

  It’s important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse. […] So, if you’re having trouble coping with postpartum depression, talk with your health care provider. […] Your health care provider or mental health provider may ask you some questions, such as: What are your symptoms, and when did they start? […] Your provider may ask additional questions based on your responses, symptoms and needs. Preparing for questions will help you make the most of your appointment.

• #2 Postpartum Depression: Symptoms, Causes, and More

  https://www.healthline.com/health/depression/postpartum-depression

  Postpartum depression is a serious condition, and there are treatment options that can help you feel better. […] If you experience symptoms of postpartum depression for more than 2 weeks within the first year of giving birth, contact a healthcare professional for a postpartum depression screening. […] A medical professional will be able to assess your symptoms and medical history to reach a diagnosis. […] Theyll typically look for and ask you about: depression symptoms, disturbances to sleep patterns, feelings of decreased energy, feelings of irritability. […] As part of the diagnosis, your doctor will identify other risk factors of depression and associated conditions, which include: recent stressful life events, a history of depression, outside stressors, your medication history. […] They may also order a blood test to check if a disorder like thyroid disease or a nutrient deficiency may be contributing to your depression.

• #2 Postpartum Major Depression | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1015/p926.html

  The diagnosis of postpartum major depression should also include asking patients about past manic episodes. […] Because hypothyroidism may also cause depressive symptoms, physicians should measure thyroid-stimulating hormone levels in women with suspected postpartum major depression. […] The Edinburgh Postnatal Depression Scale can be used to monitor progress over time.

• #2 Patient Screening | ACOG

  https://www.acog.org/programs/perinatal-mental-health/patient-screening

  After a woman completes the screening tools, they should be scored by clinical staff, entered into the chart, and included in an electronic medical record. […] It is imperative that they are scored before a woman leaves her appointment, so that a positive screen can be promptly addressed. […] You may consider screening all women for bipolar disorder. Minimally it needs to be done prior to initiating an antidepressant because 1 in 5 women who screen positive for depression may have bipolar disorder. […] Treatment of bipolar disorder with an antidepressant alone is contraindicated and is associated with worsening of mood symptoms which can increase risk of mania, psychosis, and suicide. […] In general, if bipolar disorder is suspected, consultation with or referral to psychiatry for further assessment is indicated.

• #2 Postpartum Depression: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression

  Postpartum depression can last until one year after your child is born. […] Talk to your healthcare provider about your symptoms and treatment. […] Contact your healthcare provider if you think you have postpartum depression. […] There isn’t a specific test that diagnoses postpartum depression. Your healthcare provider will evaluate you at your postpartum visit. […] Many providers schedule visits at two or three weeks postpartum to screen for depression. […] They may do a depression screening or ask you a series of questions to assess if you have postpartum depression. […] If your provider feels you have signs of postpartum depression, they will recommend an appropriate treatment. […] Postpartum depression is treated differently depending on the type and severity of your symptoms.

• #2 How Doctors Diagnose and Treat Postpartum Depression. Medications and Treatment Overview

  https://www.webmd.com/depression/postpartum-depression/understanding-postpartum-depression-treatment

  Despite the fact that postpartum depression has been known about for a long time, many experts believe it isnt being properly diagnosed. […] If a woman is at risk, their doctor can evaluate their moods throughout the pregnancy. After a woman gives birth, they and those close to them should watch for symptoms of depression. Their doctor should look for such signs at their 6-week postpartum visit, as well. […] Theres no blood test or body scan that shows you have this mood disorder. Instead, your doctor will ask certain questions about your state of mind. […] If you have symptoms of postpartum depression, your doctor will evaluate their severity, including asking about whether you have thoughts of harming yourself or your baby. […] Your thyroid levels also may be checked to make sure the gland is working the way it should. Hypothyroidism can cause the same symptoms as postpartum depression.

• #2 Postnatal Depression: Causes and Treatment | Doctor

  https://patient.info/doctor/postnatal-depression-pro

  At booking and at postnatal checks, all health professionals should consider mental health screening questions. […] If the answer is „yes” to any of these questions, or if there is clinical concern, further assessment is required. This may be by the use of a formal assessment tool, such as the Patient Health Questionnaire (PHQ-9), the Edinburgh Postnatal Depression Scale or the Generalised Anxiety Disorder Scale (GAD-7). […] NICE advises that assessment of any mental health problem in either pregnancy or the postnatal period should include the following: Past history or family history of any mental health problem. Also any current or past treatment for a mental health problem and response to any treatment. […] Women should be proactively screened for mental health problems, and high-risk patients identified. It is advised that when women present for booking and at the postnatal check, health professionals (including midwives, obstetricians, health visitors and GPs) should ask questions to screen for depression and anxiety.

• #2 Postpartum Depression: Symptoms, Causes, Risks, Types, Tests, Professional and Self-Care

  https://www.webmd.com/depression/postpartum-depression

  Postpartum depression (PPD) is a complex mix of physical, emotional, and behavioral changes that happen in some women after giving birth. According to the DSM-5, a manual used to diagnose mental disorders, PPD is a form of major depression that begins within 4 weeks after delivery. The diagnosis of postpartum depression is based not only on the length of time between delivery and onset but on the severity of the depression. […] Symptoms of postpartum depression can be hard to detect. Many women have these symptoms following childbirth: Trouble sleeping, Appetite changes, Severe fatigue, Lower libido, Frequent mood changes. […] Untreated postpartum depression can be dangerous for new moms and their children. A new mom should seek professional help when: Symptoms persist beyond 2 weeks, They cant function normally, They can’t cope with everyday situations, They have thoughts of harming themselves or their baby, They’re feeling extremely anxious, scared, and panicked most of the day.

• #2 What Is Postpartum Depression (PPD)?

  https://www.everydayhealth.com/postpartum-depression/guide/

  Postpartum depression often goes unaddressed, in part because parents may be ashamed of feeling down during what they believe should be a time of joy. […] Research in the United States has shown that routine postpartum depression screenings can improve outcomes for pregnant parents and their families. […] Screening for postpartum depression in pregnant and postpartum women is now recommended by the American College of Obstetricians and Gynecologists (ACOG), the American Psychiatric Association (APA), and the American Academy of Pediatrics (AAP). […] To be diagnosed with postpartum depression, symptoms must begin during pregnancy or within a year of giving birth.

• #2 New Research Highlights Inequities in Diagnosis, Treatment of Postpartum Depressive Symptoms | Columbia University Mailman School of Public Health

  https://www.publichealth.columbia.edu/news/new-research-highlights-inequities-diagnosis-treatment-postpartum-depressive-symptoms

  The study findings suggest that policies that require and reimburse universal mental health screening at postpartum visits, ensure connections to care, reduce gaps in postpartum insurance coverage, and require clinician training in culturally responsive resources could improve equity of postpartum depression diagnosis and care in the U.S. […] Improving equitable access to PMAD diagnosis and treatment is thus critical to addressing the maternal health crisis in the U.S., said Daw.

• #3 Diagnosis and Management of Postpartum Depression

  http://www.fortunejournals.com/articles/diagnosis-and-management-of-postpartum-depression.html

  Postpartum Depression (PPD) is a severe mental health problem that affects up to 15% of mothers. […] The obstetrician, pediatrician and primary health care physicians have a crucial role in screening for and treating PPD. […] This review aims to provide a holistic approach for PPD diagnosis and management. […] The clinical features of postpartum major depression appear comparable to those of major depressive episodes that occur outside of the postpartum period. […] Postpartum depression is diagnosed when at least five depressive symptoms are present for at least two weeks. […] The diagnosis should include depression or anhedonia (loss of interest) and five symptoms. […] Screening for PPD can be done 2 to 6 months after childbirth. […] Based upon practice guidelines issued by the United States Preventive Services Task Force, primary care clinicians (including obstetricians, gynaecologists, or pediatricians) should screen all postpartum women for depression.

• #3 Postpartum depression – Wikipedia

  https://en.wikipedia.org/wiki/Postpartum_depression

  Postpartum depression, also called perinatal depression, is a mood disorder which may be experienced by pregnant or postpartum individuals. Symptoms include extreme sadness, low energy, anxiety, crying episodes, irritability, and extreme changes in sleeping or eating patterns. Diagnosis is based on a person’s symptoms. While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks. […] Diagnosis is based on a person’s symptoms. […] Postpartum depression in the DSM-5 is known as „depressive disorder with peripartum onset”. Peripartum onset is defined as starting anytime during pregnancy or within the four weeks following delivery. There is no longer a distinction made between depressive episodes that occur during pregnancy or those that occur after delivery. Nevertheless, the majority of experts continue to diagnose postpartum depression as depression with onset anytime within the first year after delivery. […] The criteria required for the diagnosis of postpartum depression are the same as those required to make a diagnosis of non-childbirth-related major depression or minor depression. The criteria include at least five of the following nine symptoms, within two weeks.

• #3 Postpartum Depression – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/postpartum-depression

  Postpartum depression is depressive symptoms during the first year after delivery that last 2 weeks and meet criteria for major depression. […] Postpartum depression is diagnosed based on the same criteria as major depressive disorder, which are 5 symptoms for 2 weeks; symptoms include depressed mood and/or loss of interest or pleasure and (2) […] Early diagnosis and treatment of postpartum depression substantially improve outcomes for women and their infant. […] All women should be screened at the postpartum visit for postpartum depression using a validated screening tool. […] The diagnosis of postpartum depression requires that symptoms be present for 2 weeks.

• #3

  https://journals.lww.com/jaapa/fulltext/2013/02000/postpartum_depression__symptoms,_diagnosis,_and.9.aspx

  A total score of greater than 12 or any positive response to the item the thought of harming myself has occurred to me should prompt a more complete assessment for depression. […] A positive screen should prompt the clinician to conduct a complete interview to determine if the patient meets criteria for a major depressive episode. […] Major depressive disorder, as outlined in the DSM-IV-TR, is characterized by a possible symptom combination of depressed mood, anhedonia, change in weight or appetite, sleep disturbance, inappropriate guilt, psychomotor disturbance, fatigue, diminished concentration, or thought of death or suicide. […] Five of these symptoms must be present within a 2-week period, and one of the five must be either depressed mood or anhedonia to make a diagnosis of MDD.

• #3 Postpartum Depression: Diagnosis, Symptoms, Treatment

  https://familydoctor.org/condition/postpartum-depression/

  Postpartum depression is a mental health illness that affects women after giving birth. For some women, it is normal to feel the “baby blues” for a week or two after giving birth. With postpartum depression, feelings of sadness, loneliness, worthlessness, restlessness, and anxiety may last longer than two weeks. […] Schedule a visit with your doctor if you suspect you have postpartum depression. Your doctor will talk to you about your symptoms and feelings. He or she will ask you how long you have been feeling depressed. Your doctor may ask you to complete a questionnaire about your depression or order a blood test to check your hormone levels. […] Additionally, the American Academy of Family Physicians (AAFP) recommends screening for depression in the general adult population. This includes pregnant and postpartum women. Screening efforts should focus on ensuring accurate diagnosis, effective treatment, and appropriate follow up.

• #3 Postpartum Depression Epidemiology, Risk Factors, Diagnosis, and Management: An Appraisal of the Current Knowledge and Future Perspectives

  https://www.mdpi.com/2077-0383/14/7/2418

  Currently, 12 available instruments have been designed to assess the risk factors of PPD. […] The Edinburgh Postnatal Depression Scale is considered the gold standard in screening for PPD. […] The validation and analysis of the EPDS’s items have been carried out in a large variety of studies/samples and in different countries and cultures. […] The use of the EPDS as a „gold standard” of postpartum depression may minimize the importance of postpartum anxiety symptoms. […] There are many more instruments that have been validated and utilized for PPD diagnosis; however, when choosing between one and another, their reliability and cultural validation results should be taken into consideration.

• #3 Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care

  https://www.mdpi.com/2075-4418/14/9/865

  Patients with risk factors should be screened with the Edinburgh Postnatal Depression Scale (EPDS). […] The Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Depression Screening Scale (PDSS) are used specifically for the diagnosis of postnatal depression, while the Patient Health Questionnaire (PHQ-9) is recommended for the diagnosis of depression in psychiatric medical institutions. […] Obstetricians should include brief screening methods for PPD in the evaluation of pregnant women during their visits. Thus, if PPD is diagnosed, patients should be informed about all therapeutic techniques.

• #3 Postpartum Depression: Symptoms, Causes, and More

  https://www.healthline.com/health/depression/postpartum-depression

  Postpartum depression is a serious condition, and there are treatment options that can help you feel better. […] If you experience symptoms of postpartum depression for more than 2 weeks within the first year of giving birth, contact a healthcare professional for a postpartum depression screening. […] A medical professional will be able to assess your symptoms and medical history to reach a diagnosis. […] Theyll typically look for and ask you about: depression symptoms, disturbances to sleep patterns, feelings of decreased energy, feelings of irritability. […] As part of the diagnosis, your doctor will identify other risk factors of depression and associated conditions, which include: recent stressful life events, a history of depression, outside stressors, your medication history. […] They may also order a blood test to check if a disorder like thyroid disease or a nutrient deficiency may be contributing to your depression.

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