Improving Patient Identification, Shared Decision Making, and Connections to Care for Postpartum Depression-PPD Handouts

PPD Handouts

Pdf Summary

The ACOOG 2024 webinar on postpartum depression (PPD), led by Dr. Melisa Lott, aims to enhance the diagnostic and management skills of obstetrician-gynecologists (OB-GYNs). It focuses on accurate identification, critical evaluation of consequences, and interdisciplinary collaboration.<br /><br />**Definition and Consequences:**<br />PPD is defined as a major depressive disorder starting during pregnancy or up to 12 months postpartum. It significantly impacts maternal, fetal, and neonatal outcomes, such as preterm birth and impaired bonding. Unaddressed PPD can lead to severe consequences like maternal suicide and infant mortality.<br /><br />**Diagnostic Approach:**<br />OB-GYNs are trained to screen for PPD using validated tools like the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9). Symptoms include depressed mood, loss of interest, insomnia, and recurrent thoughts of death. A case study in the webinar illustrates a stressed patient with difficulty bonding with her newborn, underscoring the importance of timely and correct PPD diagnosis.<br /><br />**Risk Factors:**<br />PPD risk factors include a history of mental health issues, lack of partner support, and environmental stressors like intimate partner violence. Data suggests that PPD prevalence peaks postpartum, affecting up to 40% of women.<br /><br />**Management Strategies:**<br />A multidisciplinary approach is encouraged, involving shared decision-making with patients and collaboration with mental health professionals. First-line treatment includes psychotherapy and, when necessary, pharmacotherapy, typically selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).<br /><br />**Barriers to Care:**<br />Challenges include limited access to mental health providers, societal stigma, cultural beliefs, and geographic barriers. Overcoming these involves better communication and coordinated care strategies between OB-GYNs, primary care, and mental health services.<br /><br />**Key Points and Takeaways:**<br />OB-GYNs should screen for PPD during all patient interactions using validated instruments. Timely, patient-centered care involving shared decision-making can improve outcomes. Close follow-up and appropriate handoffs to primary care or psychiatry are essential for ongoing management and ensuring comprehensive care.<br /><br />The session concludes by reiterating the critical role of OB-GYNs in diagnosing and managing PPD, emphasizing the benefits of early intervention and interdisciplinary collaboration.

Keywords

postpartum depression

PPD

obstetrician-gynecologists

diagnostic skills

management strategies

maternal outcomes

Edinburgh Postnatal Depression Scale

risk factors

multidisciplinary approach

barriers to care