Postpartum Depression Assessment and Management

Depression Screening Assessment

• The American Academy of Family Physicians recommends the Edinburgh Postnatal Depression Scale (EPDS) as the primary screening tool for postpartum depression, with a score range of 0-30, where scores ≥10 indicate possible depression, and it should be administered at the initial encounter, with the strongest evidence base (class A recommendation) 1, 3
• The EPDS consists of 10 questions evaluating symptoms over the past 7 days, and the Patient Health Questionnaire-9 (PHQ-9) is an acceptable alternative screening tool that can assess current depression severity and treatment response 2, 4, 5, 6
• It is essential to document any suicidal ideation carefully, as this is frequently underreported in clinical documentation despite being captured on screening tools 5

Clinical Assessment Components

• The American Academy of Family Physicians suggests documenting therapy engagement, frequency, and perceived effectiveness, and screening for comorbid anxiety symptoms, which commonly co-occur with postpartum depression 7, 8

Documentation and Follow-up Planning

• The American Academy of Family Physicians recommends documenting current depression severity using validated screening tool scores, and creating a clear follow-up plan with scheduled reassessment of depression symptoms, and documenting any safety concerns and creating a safety plan if indicated 1, 7