Depression is common among pregnant women and mothers with small children. In urban, high-risk populations of mothers, depression rates may reach upwards of 40% (Heneghan et al 1998).  Many cases of perinatal depression go unrecognized and untreated, often with significant negative consequences for both mothers and their families.  Women are especially at-risk for depressive symptoms during the perinatal period, with the greatest period of risk during pregnancy (Evans et al 2001).  This webpage provides information and local resources for health and mental health providers who care for Cleveland mothers, pregnant women, and their families.


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Contents

  • CRPN Perinatal Depression Training page click here

  • Clinical Overview of Perinatal Depession

  • Screening and Diagnosis

  • Treatment: Counseling and Medications

  • Local Resources for Pregnant and Postpartum Women

  • Handouts and Short Fact Sheets For Mothers and Families

  • Continuing Education in Perinatal Depression

  • Professional Organizations


Clinical Overview of Perinatal Depression

 

The following websites provide brief overviews of perinatal depression. Some sites only discuss postpartum depression; however, many of the same principles apply to characteristics  of and care for depression during pregnancy.

 

Mood and anxiety disorders during pregnancy and the postpartum period

Miriam B. Rosenthal, MD, Associate Professor of Psychiatry and Reproductive Biology

Case Western Reserve University

See article

 

CRPN Perinatal Depression Project/Cuyahoga Perinatal Depression Task Force - 2011 Education Forum on Perinatal Depression

View Presenters powerpoint presentations below:

Update on Medical Management of Depression and Anxiety in Pregnancy Sarah Nagle-Yang, MD

Alternative Treatment Options for Perinatal Depression Ben Kearney, Ph.D

 

2002 Cleveland Healthy Family/Healthy Start Perinatal Depression Project, Feelings of African American Perinatal Women.

See summary report

 

The Challenges of Diagnosing and Treating Maternal Depression

The American College of Obstetricians and Gynecologists

www.acog.org/from_home/publications/press_releases/nr05-07-07-2.cfm

 

Depression During and After Pregnancy; A Resource for Women, Their Families, and Friends

A free booklet produced by the the U.S. Department of Health and Human Services Administration

www.mchb.hrsa.gov/pregnancyandbeyond/depression

 

Depression in Pregnancy

Dartmouth-Hitchcock Medical Center

www.dhmc.org/webpage.cfm?site_id=2&org_id=804&gsec_id=41775&sec_id=41782&item_id=41788

 

Depression in Women: National Mental Health Association

www.mentalhealthamerica.net/index.cfm?objectid=C7DF952E-1372-4D20-C8A3DDCD5459D07B

 

Professional and consumer education in English and Spanish supported by the National Institute of Mental Health.

MedEdPPD

www.mededppd.org

 

Summit on Women and Depression

American Psychological Association

http://www.apa.org/pi/women/programs/depression/summit-2002.pdf


 

Screening and Diagnosis

 

The U.S. Preventive Services Task Force recommends screening adults for depression in clinical practices where systems are in place to assure accurate diagnosis, effective treatment, and followup. Even pediatric providers are strongly encouraged to screen their patients’ parents because of the potential negative consequences of parental mental health problems on children (Bright Futures in Practice: Mental Health Practice Guide, 2002). Several validated instruments have been developed to screen adult women for depression. Many of these instruments have simple scoring techniques, designed to allow for processing during an office visit.

 

Screening for Depression: U.S. Preventive Services Task Force Recommendations and Rationale

www.ahcpr.gov/clinic/3rduspstf/depression/depressrr.htm

Screening for Depression Across the Lifespan: A Review of Measures for Use in Primary Care Settings. 

American Academy of Family Physicians. 2002.

www.aafp.org/afp/20020915/1001.html

 

Parental Depression: Bright Futures Mental Health Practice Guide (Vol 1)

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.

www.brightfutures.org/mentalhealth/

 

Edinburgh Postnatal Depression Scale (EPDS)

One-page, 10-item validated screening instrument developed to assist primary care health professionals in detecting mothers who may be suffering from perinatal depression.

 http://fcmc.weebly.com/uploads/3/4/8/9/3489838/edinburghscale.pdf

 

Screening Instruments for Management of Major Depressive Disorder in Adults

Screening tools reproduced for consideration in local settings, with information on sensitivity and specificity: PRIME MD Primary Care Evaluations of Mental Disorders–Depression Questions (2 items); CES-D Center for Epidemiological Studies–Depression Scale (5 items); Zung Depression Rating Scale (21 items); BDI Beck Depression Inventory (21 items); MOS Medical Outcomes Study–depression questions (4 items); Ham-D Hamilton Depression Scale (21 items).

www.healthquality.va.gov/Major_Depressive_Disorder_MDD_Clinical_Practice_Guideline.asp

 


 

Treatment: Counseling and Medications

 

Use of psychoactive medication during pregnancy and possible effects on the fetus and newborn (RE9866).

American Academy of Pediatrics, Committee on Drugs. Pediatrics 2000; 105: 880-7.

aappolicy.aappublications.org/cgi/reprint/pediatrics;105/4/880.pdf

 

Medications for Depression: During the Childbearing Years

National Insitute of Mental Health. 2002.

www.nimh.nih.gov/publicat/medicate.cfm

 

PubMed

National Library of Medicine. Search over 14 million citations for biomedical articles.

www.pubmed.gov

 

Maternal and Child Health Library: Postpartum Depression

Annotated bibliography of sources of information about postpartum depression.

www.mchlibrary.info/KnowledgePaths/kp_postpartum.html

 

Treatment of Depression During Pregnancy

Chronological list of references.

www.pregnancyanddepression.com

 


 

Local Resources for Pregnant and Postpartum Women 

 

 

 

More resources and referrals to a wide range of health and human services in Cuyahoga County can also be found at First Call for Help.   www.uws.org/fcfh

Network of Care sponsored by Lorain County Board of Mental Health contains mental health information for providers and consumers as well as links to services.  www.lorain.oh.networkofcare.org/mh

 


 

Handouts and Short Fact Sheets for Mothers and Families

These handouts are already in printable form, many with appealing layouts and graphics. Some brochures may be ordered for little to no cost.

 

Depression: What Every Woman Should Know

National Institute of Mental Health. Brochure can be ordered; also available in pdf format.

www.nimh.nih.gov/publicat/depwomenknows.cfm

 

Depression in Women

American Academy of Family Physicians (AAFP). Patient information handout.

www.aafp.org/afp/990700ap/225.html

 

Taking Care of Both of You: Understanding Mood Changes after the Birth of your Baby

Depression and Bipolar Support Alliance (formerly National Depressive and Manic-Depressive Association).

www.dbsalliance.org/site/PageServer?pagename=about_publications_postpartum

 

Patient Information Sheet: Postpartum Depression

The Postpartum Stress Center, Rosemont, PA. Two-page handout (may be copied double-sided).

www.postpartumstress.com/docs/Patient%20Info%20sheet.pdf

 

Factsheet: Postpartum Disorders

National Mental Health Association.

 http://www.mentalhealthamerica.net/index.cfm

For Mothers: Tips for Talking with a Health Care Provider about Postpartum Depression

www.postpartumstress.com/pages/tips.html

 


 

Continuing Education in Perinatal Depression

 

Bright Futures in Practice: Mental Health

Early recognition and intervention for pediatric and parental mental health problems. Mental health tool kit contains resources for screening, care management, and health education.

www.brightfutures.org/training/MH/MH_Fact_sheet.pdf

 

The Postpartum Stress Center Postgraduate Training Program: “Become an Expert in the Treatment of Postpartum Mood Disorders”

The Postpartum Stress Center, Rosemont, PA. A professional course on perinatal mental health.

www.postpartumstress.com/pages/professional_training.html


 

Professional Organizations

 

The Marcé Society: An International Society of the Understanding, Prevention and Treatment of Mental Illness Related to Childbearing

A multidisciplinary organization that seeks to bring together different strands of research regarding pregnancy-related mental disorders.

www.marcesociety.com

 

Association for Pre- & Perinatal Psychology and Health

Professional and lay organization that provides “a forum for individuals from diverse backgrounds and disciplines interested in psychological dimensions of prenatal and perinatal experiences.”

 www.birthpsychology.com