Division of Management, Policy, and Community Health, School of Public Health, The University of Texas, Houston, TX 77030, USA.
Arch Womens Ment Health. 2012 Apr;15(2):115-20. doi: 10.1007/s00737-012-0262-6. Epub 2012 Mar 1.
This study was developed to evaluate the feasibility of implementing systematic depression screening in a large obstetric practice and to evaluate the degree that detection and referral led to linkage with behavioral healthcare. Depression screening was conducted using the Edinburgh Postnatal Depression Scale, administered at the initial pregnancy care appointment. Patients at or above a predetermined score of 14 were advised to seek further behavioral health assessment through the patient's behavioral healthcare coverage. Within 4 weeks of screening, those referred were contacted by telephone, by clinic staff, to determine whether they had pursued behavioral healthcare as recommended. Limited available data for newly established postdelivery screening were similarly evaluated. All 2,199 newly presenting pregnant women who were seen in our obstetric clinics from September 2008 to May 2009 were screened for depression, and 102 (4.6%) scored at or above an EPDS of 14. Follow-up calls revealed that none had pursued further behavioral health assessments. Of these 2,199, screening and follow-up data were available for 569 women at their 6-week postdelivery visit. Of these, 28 (4.9%) were above EPDS of 14, and 5 (17.9%) reported pursuit of further behavioral healthcare following screening and referral. Peripartum depression can be addressed with systematic screening, and the electronic medical record can readily be used to monitor results. Detection and referral at the beginning of pregnancy did not lead to intended linkage with behavioral healthcare, but detection and referral postdelivery had a modest influence. Barriers to pursuing behavioral healthcare need to be discovered and addressed.
这项研究旨在评估在大型产科实践中实施系统抑郁症筛查的可行性，并评估检测和转介的程度，以与行为保健建立联系。在初始妊娠保健预约时，使用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）进行抑郁症筛查。得分达到或高于预定的 14 分的患者被建议通过患者的行为健康保险寻求进一步的行为健康评估。在筛查后的 4 周内，通过电话联系转介患者，以确定他们是否按照建议寻求了行为保健。对于新建立的产后筛查，也对有限的可用数据进行了类似的评估。2008 年 9 月至 2009 年 5 月期间，我们的产科诊所共对 2199 名新出现的孕妇进行了抑郁症筛查，其中 102 名（4.6%）的 EPDS 得分达到或高于 14。随访电话显示，没有一人接受进一步的行为健康评估。在这 2199 名患者中，有 569 名在产后 6 周的就诊时有筛查和随访数据。其中，28 名（4.9%）的 EPDS 得分高于 14，5 名（17.9%）在筛查和转介后报告接受了进一步的行为保健。可以通过系统筛查来解决围产期抑郁症问题，并且电子病历可以方便地用于监测结果。在妊娠早期的检测和转介并没有导致预期与行为保健的联系，但产后的检测和转介有一定的影响。需要发现和解决寻求行为保健的障碍。
