Identification and treatment of postnatal depression in primary care

Abstract

Perinatal mental illness can result in significant morbidity. Most of these illnesses are depressive and anxiety disorders. A systematic review of 28 prospective studies carried out in 11 different countries showed that the prevalence of perinatal depression amongst new mothers during the antenatal months and the first few months postpartum was 12.9%. It is thus very important that postnatal depression is identified. The two ‘Whooley questions’ (“During the past month, have you often been bothered by feeling down, depressed or hopeless?” and “During the past month have you often been bothered by little interest or pleasure in doing things?”) together with the ‘Aroll question’ (“Is this something with which you would like help?”) can be used to screen for depression. Treatment of postnatal depression can include non-pharmacological and/or pharmacological measures. Breastfeeding intentions should be taken into account when planning treatment for these mothers.