The practices were randomised to provide usual care or a multistep intervention in which staff were trained to screen and manage depression.
A total of 2343 women were enrolled five to 12 weeks after giving birth. Depressive symptoms were present in 25.8% of the women in the usual-care practices and in 29.5% in the intervention practices. However, the diagnosis of postpartum depression was only made by usual care in 41% of cases, but in the intervention group 66% were diagnosed.
Women in the intervention practices were more likely to be treated. After 12 months, they had significantly fewer depressive symptoms.
Women in the intervention group were more likely to be given antidepressant drugs. As the incidence of moderate to severe depression was similar in both groups, it suggests the intervention practices prescribed drugs for those with milder symptoms.
The study did not show the intervention was significantly better than usual-care in the first six months of treatment. For both groups, the key to a good outcome was making the diagnosis of postpartum depression.
As first appeared in Medical Observer, 21 MAY 2013. Source: Ann Fam Med 2012;10:320-29