Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines

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• 作者：Marie-Paule V. Austin^a ; ^b ; ^{m.austin@unsw.edu.au} ; Philippa Middleton^c ; Nicole M. Reilly^a ; ^b ; Nicole J. Highet^d
• 关键词：Postpartum depression ; Systematic review ; Depression screening ; Psychosocial assessment ; Perinatal mood disorders
• 刊名：Women and Birth
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：26
• 期：1
• 页码：2-9
• 全文大小：297 K

文摘

Background

Mood disorders arising in the perinatal period (conception to the first postnatal year), occur in up to 13 % of women. The adverse impact of mood disorders on mother, infant and family with potential long-term consequences are well documented. There is a need for clear, evidence-based, guidelines for midwives and other maternity care providers.

Aim

To describe the process undertaken to develop the Australian Clinical Practice Guidelines for Depression and Related Disorders in the Perinatal Period and to highlight the key recommendations and their implications for the maternity sector.

Method

Using NHMRC criteria, a rigorous systematic literature review was undertaken synthesising the evidence used to formulate graded guideline recommendations. Where there was insufficient evidence for recommendations, Good Practice Points were formulated. These are based on lower quality evidence and/or expert consensus.

Findings

The quality of the evidence was good in regards to the use of the Edinburgh Postnatal Depression Scale and psychological interventions, but limited as regards medication use and safety perinatally. Recommendations were made for staff training in psychosocial assessment; universal screening for depression across the perinatal period; and the use of evidence based psychological interventions for mild to moderate depression postnatally. Good Practice Points addressed the use of comprehensive psychosocial assessment - including risk to mother and infant, and consideration of the mother-infant interaction - and gave advice around the use and safety of psychotropic medications in pregnancy and breastfeeding. In contrast to their international counterparts, the Australian guidelines emphasize a more holistic, woman and family centred approach to the management of mental health and mood disorders in the perinatal setting.

Conclusion

The development of these Guidelines is a first step in translating evidence into practice and providing Australian midwives and other maternity care providers with clear guidance on the psychosocial management of women and families.