Gordon Trent E J, Cardone Ida A, Kim Jennifer J, Gordon Scott M, Silver Richard K
Evanston Northwestern Healthcare, the Jennifer Mudd Houghtaling Postpartum Depression Program, Department of Obstetrics & Gynecology, Psychiatry, Northwestern University's Feinberg School of Medicine, Evanston, IL 60201, USA.
Obstet Gynecol. 2006 Feb;107(2 Pt 1):342-7. doi: 10.1097/01.AOG.0000194080.18261.92.
To develop a department-based program to identify and treat women at risk for perinatal depression.
Private and employed physician groups were engaged to conduct antepartum maternal depression screening using the Edinburgh Postnatal Depression Scale. A comprehensive program was established to ensure that patients identified as being at risk would receive appropriate care. The program 1) developed a network of existing community mental health providers to accommodate screen-positive referrals, 2) created a 24/7 hotline staffed by mental health workers to respond to urgent/emergent patient needs, 3) provided nursing and physician education via a comprehensive curriculum on perinatal depression, and 4) facilitated outpatient depression screening that included a centralized scoring and referral system.
A total of 4,322 women completed 4,558 screens during the initial 24 months (June 2003-May 2005). Although initial uptake of the screening program was gradual, all 20 departmental obstetric practices were screening their patients at the end of the first year. Depression screening was accomplished between 28-32 weeks of gestation, and postpartum screening (during the 6-week postpartum visit) was subsequently added. Overall, 11.1% of women screened positive in the antenatal period, and 7.3% screened positive in the postnatal period. Three hundred three women were referred for evaluation and care.
Department-based, perinatal depression screening was feasible when individual physician practices were not required to develop the infrastructure necessary to respond to at-risk patients. We believe that the provision of clinical safety nets (mental health provider network and the hotline) were essential to the universal acceptance of this program by practitioners.
III.
制定一项基于科室的项目，以识别和治疗有围产期抑郁症风险的女性。
聘请私人执业医生团队和受雇医生团队，使用爱丁堡产后抑郁量表进行产前产妇抑郁筛查。建立了一个综合项目，以确保被确定有风险的患者能得到适当护理。该项目：1）建立了一个由现有社区心理健康服务提供者组成的网络，以接收筛查呈阳性的转诊患者；2）设立了一条由心理健康工作者值守的全天候热线，以应对患者的紧急需求；3）通过关于围产期抑郁症的综合课程，为护士和医生提供教育；4）推动门诊抑郁筛查，包括一个集中评分和转诊系统。
在最初的24个月（2003年6月至2005年5月），共有4322名女性完成了4558次筛查。尽管筛查项目的最初参与人数增长缓慢，但到第一年末，所有20个科室的产科诊疗机构都在对其患者进行筛查。抑郁筛查在妊娠28至32周期间进行，随后增加了产后筛查（产后6周复诊时）。总体而言，11.1%的女性在孕期筛查呈阳性，7.3%的女性在产后筛查呈阳性。303名女性被转诊接受评估和治疗。
当不需要个别医生诊疗机构自行建立应对有风险患者所需的基础设施时，基于科室的围产期抑郁筛查是可行的。我们认为，提供临床安全网（心理健康服务提供者网络和热线）对于从业者普遍接受该项目至关重要。
三级。
