Nearly 1 in 4 women depressed at 1 year postpartum

Postpartum depression is a problem for almost 1 out of every 7 women and nearly one-quarter of mothers are depressed at some point in the first year after delivery, according to a study in JAMA Psychiatry.

Using the Edinburgh Postnatal Depression Scale (EPDS), researchers at an urban academic women’s hospital in Pittsburgh screened 10,000 women for depression at 4 to 6 weeks postpartum. The EPDS assesses self-harm ideation with statements and responses such as “The thought of harming myself has occurred to me” with responses to choose from including “yes, quite often;” “sometimes;” “hardly ever;” and “never.” Women who scored 10 or higher on the telephone screening were evaluated during home visits with the Structured Clinical Interview for DMS-IV for Axis I primary and secondary diagnoses.

Of the women who underwent EPDS screening, 1,396 (14%) had positive findings, of whom 826 (59.2%) completed home visits and 147 (10.5%) completed a telephone diagnostic interview.  Positive screening was more likely in new mothers who were younger, African American, publicly insured, single, and less well educated. In 40% of the women with depression, the episodes started after delivery, compared with during pregnancy for 33.4% and before conception in 26.5% of women.

Self-harm ideation was documented in 19.3% of women who had suffered from depression. Unipolar depressive disorders and comorbid anxiety disorders were the most common primary diagnoses and 22.6% had bipolar disorders. Strategies to differentiate women with biopolar disorder from unipolar disorders, the authors said, are needed.