Yesterday the U.S. Preventive Services Task Force (USPSTF) released a final recommendation statement on Screening for Depression in Adults. The Task Force recommends that clinicians screen ALL ADULTS for depression and notes that the evidence indicates that screening in the primary care setting is beneficial. Echoing the recommendations made by the American College of Obstetricians and Gynecologists last year, the USPSTF highlights the importance of screening in populations at particularly high risk for depression: pregnant and postpartum women.
In that the USPSTF recommendation recognizes pregnant and postpartum women as a group at high risk for depression, this represents a step in the right direction in terms of ensuring that psychiatric illness in this vulnerable population is identified and appropriately treated. However, there remain significant obstacles to overcome. Research and clinical experience indicate that while pregnant and postpartum women with mood and anxiety disorders can be identified through screening, many women identified in this manner do not seek or are not able to find treatment.
While screening is important, we must also make sure we tend to the construction of a system that provides appropriate follow-up and treatment. Because stigma continues to be significant with regard to mental health issues in mothers and mothers-to-be and because there are concerns regarding the use of medication in pregnant and nursing women, we must make sure that after screening, we help women to access appropriate resources and treaters who have expertise in the treatment of women during pregnancy and the postpartum period.
Ruta Nonacs, MD PhD