Enquiry to detect depression in pregnancy and after birth

Depression in pregnant and postpartum people is a serious problem. Rather than using a screening tool with a cut-off score to detect depression in every pregnant and postpartum patient, clinicians should ask patients about their well-being as part of usual care, recommends a new guideline from the Canadian Task Force on Preventive Health Care published in CMAJ (Canadian Medical Association Journal).

However, there is little evidence that universal screening for depression using a standard questionnaire and cut-off score improves longer-term outcomes for these patients, indicating more research is needed.

researchers were disappointed to find insufficient evidence of benefit to universal screening with a questionnaire and cut-off score; rather, it's best for primary care clinicians to focus on asking patients about their well-being at visits,the emphasis is on an individualized rather than one-size-fits-all approach.

In creating the guideline, the task force engaged patients to understand their values and preferences around screening to inform recommendations. Participants felt strongly that a discussion about depression with their health care provider during pregnancy and the postpartum period is critical.

The guideline is aimed at health care providers in Canada, including physicians, nurses, midwives and other health care professionals who interface with pregnant and postpartum patients. It replaces the previous guideline from the task force, published in 2013.

Reference: "Regular enquiry about well-being vs. universal screening recommended to detect depression in pregnancy and after birth" CANADIAN MEDICAL ASSOCIATION JOURNAL; DOI-10.1503/cmaj.220290.