Horowitz, JA, Cousins, A. (2006). Nursing Research, 55(2S), S23-27

Postpartum depression (PPD) is a critically important, common health problem. This study examined mental health treatment rates at 3 and 4 months postpartum for 117 women who were identified with PPD symptoms at 2-4 weeks after delivery. PPD impairs functional ability and interferes with self-care agency; thus, examination of treatment rates for women identified as at-risk for PPD is an important step in evaluating screening outcomes. A secondary analysis of data from a mother-infant intervention study for women with PPD symptoms was conducted with 122 women identified as having PPD through screening with the Edinburgh Postnatal Depression Scale & Beck Depression Inventory-II.

Results showed that at 3 and 4 months postpartum, only 14 women (12%) received psychotherapy and fewer received psychopharmacologic treatment (only four women received medication at 3 months, and seven women received medication at 4 months). Significantly more women with high PPD symptoms were in therapy at 3 and 4 months. Nonetheless, the overall proportion of women receiving psychotherapy was remarkably low. This is clinically significant for all the women who had PPD symptoms. Possible barriers to referral and treatment include clinician and healthcare system, third-party payment, and personal factors. The conclusions drawn from this study highlighted the need for widespread education to alert childbearing women, their families, and providers, to the critical importance of systematic PPD screening and follow-up evaluation for at-risk women. In addition, it is also important to provide effective primary care management of mild PPD and to assure access to available mental health referral systems for PPD treatment. From the findings of this study, it seems that despite growing awareness of PPD, screening is not yet standard, and obtaining appropriate clinical evaluation and treatment for PPD still remains an unmet goal.

Maaly Guimei