Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Gynaecology, Region Gävleborg, Hudiksvall, Sweden.
Eur Psychiatry. 2024 Jan 23;67(1):e14. doi: 10.1192/j.eurpsy.2024.6.
Postpartum depression affects around 12% of mothers in developed countries, with consequences for the whole family. Many women with depressive symptoms remain undetected and untreated. The aim of this study was to investigate to what extent women with depressive symptoms at 6 weeks postpartum are identified by the healthcare system, the interventions they received, and remission rates at 6 months postpartum.
Postpartum women scoring 12-30 on the Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks after delivery ( = 697) were identified from the longitudinal cohort study "Biology, Affect, Stress, Imaging and Cognition" (BASIC) in Uppsala, Sweden. A total of 593 women were included. Background and remission information at 6 months was collected from the BASIC dataset. Medical records were examined to identify interventions received.
Most women ( = 349, 58.7%) were not identified by the healthcare system as having depressive symptoms and 89% lacked any record of interventions. Remission rates at 6 months postpartum were 69% in this group. Among women identified by the healthcare system, 90% received interventions and about 50% were in remission at 6 months postpartum. The EPDS reduction during the study period was largest in the group identified by the child health services (CHS, -5.15) compared to the non-identified (-4.24, < 0.001).
Despite screening guidelines, many women with depressive symptoms had no documentation of screening or interventions by the healthcare system. Furthermore, a significant proportion did not achieve remission despite interventions. Being identified by CHS was associated with the largest reduction of symptoms. Research is needed to understand gaps in the healthcare processes, to better identify peripartum depression.
产后抑郁症影响了发达国家约 12%的母亲，对整个家庭都有影响。许多有抑郁症状的女性未被发现和治疗。本研究旨在调查产后 6 周时患有抑郁症状的女性中有多少被医疗保健系统发现，她们接受了哪些干预措施，以及 6 个月时的缓解率。
从瑞典乌普萨拉的纵向队列研究“生物学、情感、压力、成像和认知”（BASIC）中，确定产后 6 周时在爱丁堡产后抑郁量表（EPDS）上得分为 12-30 的产后女性（n=697）。共纳入 593 名女性。从 BASIC 数据集收集 6 个月时的背景和缓解信息。检查医疗记录以确定接受的干预措施。
大多数女性（n=349，58.7%）未被医疗保健系统发现有抑郁症状，89%的女性缺乏任何干预记录。该组在产后 6 个月时的缓解率为 69%。在被医疗保健系统发现的女性中，90%接受了干预措施，约 50%在产后 6 个月时缓解。与未被识别的女性相比（-4.24，<0.001），被儿童健康服务（CHS）识别的女性的 EPDS 降低幅度最大（-5.15）。
尽管有筛查指南，但许多有抑郁症状的女性没有医疗保健系统筛查或干预的记录。此外，尽管进行了干预，但很大一部分女性仍未缓解。被 CHS 识别与症状最大程度的降低相关。需要研究以了解医疗保健过程中的差距，以更好地识别围产期抑郁症。
