Thoppil John, Riutcel Terri L, Nalesnik Sally W
Obstetrics and Gynecology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Tex 78236, USA.
Am J Obstet Gynecol. 2005 May;192(5):1446-8. doi: 10.1016/j.ajog.2004.12.073.
This study was undertaken to design a process that effectively identifies and facilitates early intervention for women in an obstetrics clinic who are at risk for postpartum depression.
Under this new program, labeled ISIS (Identify, Screen, Intervene, Support), we educated our new obstetric patients and clinic staff about postpartum depression through patient education classes, departmental lectures, and handouts. Then, we implemented simple procedures to identify risk factors for depression at intake and screened for depressive symptoms at the 32-week visit using the Edinburgh Postnatal Depression Scale (EPDS). In addition, we facilitated treatment of at-risk or symptomatic patients with the introduction of a social work consultant in the clinic setting.
In an obstetric chart review, 75% of our patients were screened for depression in pregnancy. Ten percent of these women demonstrated symptoms of depression warranting further evaluation.
Preliminary data from our multidisciplinary approach suggest that educating, screening, and appropriately treating or referring these women can take place in a busy obstetric clinic.
本研究旨在设计一种流程，以有效识别并促进对产科诊所中存在产后抑郁风险的女性进行早期干预。
在这个名为ISIS（识别、筛查、干预、支持）的新项目下，我们通过患者教育课程、科室讲座和宣传资料，对新的产科患者和诊所工作人员进行了产后抑郁方面的教育。然后，我们实施了简单的程序，在患者初诊时识别抑郁风险因素，并在孕32周就诊时使用爱丁堡产后抑郁量表（EPDS）筛查抑郁症状。此外，我们通过在诊所引入一名社会工作顾问，为有风险或有症状的患者提供治疗便利。
在一次产科病历审查中，我们75%的患者在孕期接受了抑郁筛查。其中10%的女性表现出抑郁症状，需要进一步评估。
我们多学科方法的初步数据表明，在繁忙的产科诊所中，可以对这些女性进行教育、筛查以及适当的治疗或转诊。
