Implementing a Perinatal Depression Screening in Clinical Routine: Exploring the Patientʼs Perspective

Abstract

Introduction Perinatal depression (PND) is a frequently observed mental disorder, showing a prevalence of up to 20% and resulting in unfavorable maternal and neonatal outcomes. Targeted screening for PND offers the potential to identify and treat undiagnosed cases and help prevent its deleterious consequences. The aim of the present study was to evaluate participantsʼ personal attitudes and acceptance of a routine screening program for PND in pregnancy care, identify any potential underlying factors, and appraise the general perspective on perinatal mental health problems.

Methods In total, 732 women in their second trimester of pregnancy took part in a PND screening program that was incorporated in routine prenatal care using the Edinburgh Postnatal Depression Scale (EPDS) and completed a web-based survey on screening acceptance.

Results Participants viewed PND screening as useful (78.7%, n = 555/705), especially in terms of devoting attention to perinatal mental health problems (90.1%, n = 630/699), easy to complete (85.4%, n = 606/710), and without feelings of discomfort (88.3%, n = 628/711). Furthermore, women with previous or current mental health issues rated the usefulness of screening significantly higher, as did women with obstetric risks (p < 0.01 – p = 0.04). The final regression model explained 48.4% of the variance for screening acceptance.

Conclusion Patient acceptance for PND screening was high in our study cohort, supporting the implementation of screening programs in routine pregnancy care with the potential to identify, sensitize, and treat undiagnosed patients to reduce stigmatization and offer access to tailored dedicated PND care programs.

Zusammenfassung

Einleitung Die perinatale Depression (PND) ist eine häufig beobachtete psychische Störung, die mit ungünstigen mütterlichen und neonatalen Folgen assoziiert ist. Ihre Prävalenz wird auf bis zu 20% geschätzt. Ein gezieltes Screening auf PND bietet die Möglichkeit, nicht diagnostizierte Fälle zu identifizieren und zu behandeln, und könnte helfen, die schädlichen Konsequenzen einer PND zu vermeiden. Ziel dieser Studie war es, die persönliche Haltung von Teilnehmerinnen und die Akzeptanz eines Screenings auf PND als Teil der Schwangerschaftsvorsorge zu evaluieren, mögliche zugrunde liegende Faktoren zu identifizieren sowie die allgemeine Haltung zu psychischen Störungen in der perinatalen Phase zu evaluieren.

Methoden Insgesamt nahmen 732 Frauen im 2. Trimenon an einem PND-Screening-Programm teil, das in die Standard-Schwangerschaftsvorsorge integriert wurde. Dafür wurde die Edinburgh-Postnatal-Depressions-Skala (EPDS) genutzt und die Studienteilnehmerinnen füllten einen Online-Fragebogen über die Akzeptanz des PND-Screenings aus.

Ergebnisse Die Teilnehmerinnen werteten das PND-Screening als nützlich (78,7%, n = 555/705), besonders im Hinblick auf das damit verbundene höhere Interesse an Problemen der psychischen Gesundheit in der perinatalen Zeit (90,1%, n = 630/699). Die Patientinnen berichteten, dass der Fragebogen leicht auszufüllen sei (85,4%, n = 606/710), und empfanden kein Unbehagen beim Ausfüllen (88,3%, n = 628/711). Frauen, die früher oder aktuell mit Problemen der psychischen Gesundheit zu kämpfen hatten, und Frauen mit geburtshilflichen Risiken stuften den Nutzen des Screenings signifikant höher ein (p < 0,01 – p = 0,04). Das letzte Regressionsmodell erklärte die Varianz von 48,4% in der Akzeptanz des Screenings.

Schlussfolgerung Die Akzeptanz des PND-Screenings bei den Patientinnen in unserer Studienkohorte war hoch, was für die Einführung PND-Screening-Programms als Teil der Standard-Schwangerschaftsvorsorge spricht. Ein PND-Screening könnte helfen, nicht diagnostizierte Patientinnen zu identifizieren, zu sensibilisieren und zu behandeln und die Stigmatisierung dieser Patientinnen zu verringern. Patientinnen könnten dadurch Zugang zu auf ihre Bedürfnisse zugeschnittene psychische Gesundheitsprogramme bekommen.

Key words

perinatal depression - screening - Edinburgh Postnatal Depression Scale (EPDS) - acceptance - pregnancy - mental health

Schlüsselwörter

perinatale Depression - Screening - Edinburgh-Postnatal- Depressions-Skala (EPDS) - Akzeptanz - Schwangerschaft - psychische Gesundheit

Publication History

Received: 16 May 2022

Accepted after revision: 08 August 2022

Article published online:
30 September 2022

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