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Doctors say this is the best way to detect postnatal depression

Rather than using a screening tool with a cut-off score to detect depression in pregnant women and new mums, doctors should do this.

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By Stephen Beech via SWNS

Postnatal depression is best detected by doctors simply talking to their patients, according to new research.

Rather than using a screening tool with a cut-off score to detect depression in pregnant women and new mums, doctors should ask patients about their well-being as part of their usual care, and recommend new guidelines.

The recommendations by the Canadian Task Force on Preventive Health Care were published in the Canadian Medical Association Journal (CMAJ).

Professor Eddy Lang, chair of the task force's pregnancy and postpartum working group said: "Depression in pregnant and postpartum people is devastating, with a massive burden for families, and it's critical to detect it."

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

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Professor Lang added: "We 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 guidelines, 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 guidelines mean medics should ask patients about their well-being as part of their usual care, consider not using a standardized tool with a cut-off score to screen every patient, and use clinical judgment to decide on further steps.

Task force member Dr. Emily McDonald, an Associate Professor at McGill University, added: "Given the health implications of depression during pregnancy and the postpartum period, it's essential to check in with people about how they're feeling.

"If clinicians are uncertain about how to start the conversation, they could refer to questionnaires for discussion prompts, which is different than formal screening that would use a cut-off score to determine next steps."

Task force co-chair Professor Brenda Wilson, of Memorial University, Newfoundland, said: "Jurisdictions that employ formal screening may wish to reconsider this practice given the very uncertain evidence of benefit.

"What's essential is clinical vigilance for depression as part of usual care, as engaging in practices with no proven benefit can take away from other health issues."

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