Face-to-face interviews find more postnatal depression

Edinburgh Postnatal Depression Scale misses 65 per cent of cases.

GPs should diagnose postnatal depression using face-to-face interviews instead of the Edinburgh Postnatal Depression Scale (EPDS), UK research suggests.

The study found that the EPDS method, recommended by NICE in its 2007 guidance on postnatal mental health, missed 65 per cent of cases of postnatal depression. The findings add to the growing concerns that cases are being missed.

A UK study found that changes in maternity care in England have reduced contact time between GP and patient, which is vital for diagnosing depression (GP, 29 February).

The average prevalence rate of postnatal depression in the UK is estimated to be 12 per cent.

For this study, researchers randomly selected 147 antenatal women from two general practices in south London.

The women were assessed for depression three months after giving birth, completing the EPDS, a 10-item self-report questionnaire, and face-to-face interviews.

A total of 34 women were diagnosed with postnatal depression using the interview method.

However, the EPDS method identified just 12 women with postnatal depression, giving the method a sensitivity of 35 per cent.

The researchers from the Institute of Psychiatry in London concluded that 'the majority of women with a clinical diagnosis of depression were not identified by the EPDS'.

They added that 'a brief semi-structured face-to-face clinical interview may be a more accurate way of detecting those women who are depressed following childbirth'.

Dr Sarah Jarvis, RCGP spokeswoman for women's health, said: 'It can be difficult to diagnose postnatal depression using the EPDS method as patients tend to give you the answers that they think you want to hear and hide problems.

'A combination of interviewing and the EPDS is the best method for detecting postnatal depression.'

sanjay.tanday@haymarket.com

Journal of Affective Disorders 2008; 107: 241-5

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