دانلود رایگان مقاله انگلیسی ابزارهای غربالگری افسردگی پس از زایمان: یک بررسی - الزویر 2017

ABSTRACT

Purpose: The purpose of this study is to analyze the accuracy of screening tools in detecting postpartum depression (PPD). Basic Procedures: A review of the literature was conducted using PubMed, Clinical Key and Google Scholar from the years 2001 to 2016 with a modified PRISMA method. The keywords, “postnatal depression screening,” “antenatal depression screening,” and “maternal depression” were used in the search. Sixty-eight articles were reviewed, and thirty-six further analyzed. Main Findings: The accuracy of screening tools was dependent upon a number of factors. The studies reviewed differed in the types of screening tools tested; the combination of screening tools administered; the timing in which screening tools were administered; the geographic location of patients screened; and the reference standard(s) used.Principal conclusions: No tool could be deemed best at accurately detecting PPD on the basis of sensitivity and specificity. Additionally, there was no recommended time period in which screening should be done. Thus, further research is needed to elucidate the accuracy of PPD screening tools, and the best criteria to determine this.

DISCUSSION

The diagnostic performance of the available postpartum depression screening tools fluctuates depending on many factors. This discrepancy may be due to differences in the methodology of the studies such as the screening tools used; the reference standards; or a combination of tools, and the cut off scores. Results may also be influenced by the time period analyzed by the tools; the timing of screening; and the patient populations studied. These disparities in published findings make it difficult to properly compare the available tools. Consequently, no recommendation can be made about the most effective tool for detecting PPD.

Given the increased prevalence rates of PPD among low socioeconomic patients, obese patients, adolescent mothers, racial and ethnic minorities and immigrant women [4], it is important to expand research efforts to these special populations. The accuracy of screening methods must be analyzed within the context of this diversity. Additionally, clarification is needed regarding current definitions of PPD [34], and how this may change between different patient populations.