PMID- 27832221
OWN - NLM
STAT- MEDLINE
DCOM- 20170221
LR  - 20220316
IS  - 2972-4066 (Electronic)
IS  - 0304-4602 (Linking)
VI  - 45
IP  - 10
DP  - 2016 Oct
TI  - Understanding How Postnatal Depression Screening and Early Intervention Work in 
      the Real World - A Singaporean Perspective.
PG  - 466-470
AB  - Postnatal depression is a major public health problem with clearly established 
      adverse effects in child outcomes. This study examines the 4-year outcomes of a 
      screening and early intervention programme, in relation to improvement in 
      symptoms, functioning and health quality of life. Women were prospectively 
      recruited up to 6 months postdelivery, using the Edinburgh Postnatal Depression 
      Scale (EPDS) as a screening tool. High-scorers (EPDS >13), were offered 
      psychiatric consultation, and those with borderline scores (EPDS 10-12) were 
      provided counselling, and offered follow-up phone counselling by the assigned 
      case manager. Outcome measures were obtained at baseline, and at 6 months or 
      discharge if earlier, for levels of symptoms, functioning, and health quality of 
      life. From 2008 to 2012, 5245 women were screened, with 307 (5.9%) women with 
      EPDS >13 receiving intervention. Of these, 70.0% had depression, 4.6% anxiety and 
      3.4% psychosis. In the depression subgroup, the net change was improvement of 
      93.4% EPDS symptom scores, 92.2% Global Assessment of Functioning (GAF) scores, 
      and 88.3% visual analogue scale (EQ VAS) health quality of life scores. Outcome 
      scores across diagnostic categories demonstrated median changes of 10 points on 
      EPDS, 20 points on GAF, and 25 points on EQ VAS, reflecting 73.9%, 36.4% and 
      41.7% change from baseline scores. Women with psychosis showed the biggest 
      (80.0%) relative change in GAF functioning scores from baseline to discharge but 
      had the lowest median change in EPDS symptom scores. A screening and intervention 
      programme rightly-sited within an obstetric setting can improve clinical outcomes 
      because of early detection and intervention.
FAU - Lee, Theresa My
AU  - Lee TM
AD  - Department of Psychological Medicine, KK Women's and Children's Hospital, 
      Singapore.
FAU - Bautista, Dianne
AU  - Bautista D
FAU - Chen, Helen Y
AU  - Chen HY
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - Ann Acad Med Singap
JT  - Annals of the Academy of Medicine, Singapore
JID - 7503289
SB  - IM
MH  - Adult
MH  - Anxiety Disorders/diagnosis/*therapy
MH  - Case Management
MH  - Counselors
MH  - Delivery of Health Care
MH  - Depression, Postpartum/diagnosis/*therapy
MH  - *Early Medical Intervention
MH  - Female
MH  - Health Status
MH  - Humans
MH  - Mass Screening
MH  - Obstetrics
MH  - Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Psychiatry
MH  - Psychotic Disorders/diagnosis/*therapy
MH  - Puerperal Disorders/diagnosis/*therapy
MH  - Quality of Life
MH  - Referral and Consultation
MH  - Singapore
EDAT- 2016/11/11 06:00
MHDA- 2017/02/22 06:00
CRDT- 2016/11/11 06:00
PHST- 2016/11/11 06:00 [entrez]
PHST- 2016/11/11 06:00 [pubmed]
PHST- 2017/02/22 06:00 [medline]
PST - ppublish
SO  - Ann Acad Med Singap. 2016 Oct;45(10):466-470.