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• W6231690 abstract "Editor—In their review of postnatal depression Cooper and Murray comment that depression is often missed by primary care teams.1 There are several reasons why this might be the case, even though a reliable tool (the Edinburgh postnatal depression scale) has been available for detecting its presence for over 10 years.2When the Edinburgh postnatal depression scale has been used to detect postnatal depression, health visitors have used various strategies to help women, with varying degrees of success.2,3 Factors that influence the process of screening and caring for women with postnatal depression include health visitors’ workload and their willingness to use the Edinburgh postnatal depression scale3 and the readiness of women to be labelled as patients with depression, to accept an intervention by a health visitor,2–4 or to be referred for further care.2,3 There is still uncertainty about when to use the Edinburgh postnatal depression scale, where to set the threshold for the purposes of screening,2,3 and how to prioritise patients and determine which intervention is likely to be the most appropriate and effective.2–4Watson et al showed that women with postnatal depression could be classified into as many as six categories.5 Cooper and Murray’s comments on the aetiology of postnatal depression confirm their findings. McIntosh has recommended that a personalised women-centred approach is the most appropriate and more likely to be successful than reliance on just drug treatment or counselling.4Cooper and Murray highlight the impact of postnatal depression on child development and behaviour and comment that this can be a consequence of communication problems. The impact of postnatal depression on a mother’s ability to cope, which is a difficult concept to measure and evaluate, may be the most important factor affecting infant development and behaviour. In my general practice there are women who are not depressed according to a rating scale such as the Edinburgh postnatal depression scale but are not coping; others, with depression, seem to the general practitioners and health visitors to be coping. I wonder whether an approach to new mothers that focuses on their ability to cope and the resources available to help them will be more fruitful than the recommendation to diagnose depression. Clinicians in primary care teams need not feel guilty about comments from the secondary sector that they are missing patients." @default.
• W6231690 created "2016-06-24" @default.
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• W6231690 date "1998-12-12" @default.
• W6231690 modified "2023-10-14" @default.
• W6231690 title "Postnatal depression" @default.
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• W6231690 doi "https://doi.org/10.1136/bmj.317.7173.1658a" @default.
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