[Screening and barriers for treatment of postpartum depression in Chilean public primary health care centers].

BACKGROUND

Postpartum depression (PPD) is a public health issue, and appropriate screening may lead to clinical gains.

AIM

To describe the screening for PPD, its relationship with the use of health care services, and treatment access barriers in Chilean public primary health care (PHC) centers.

MATERIAL AND METHODS

Puerperal women attending PHC centers for a well-child check-up were assessed for the presence of PPD using the Edinburgh Postnatal Depression Scale and a structured psychiatric interview. PPD cases were assessed by telephone three months later. Also, women with PPD and PHC workers were interviewed to explore treatment barriers.

RESULTS

Of the 305 women assessed, 21% met diagnostic criteria for PPD. Sixty five percent of assessed women were previously screened for PPD while attending well-child check-ups. The results of the screening were communicated to 60% of them and 28% received some management indication. After three months of follow up, 70% of PPD cases continued to be depressed, and two thirds of them did not consult a health care provider and most of them rejected psychotherapy or medical treatment.

CONCLUSIONS

Management of postpartum depression should be substantially improved in public PHC from screening to treatment.