Perinatal Depression: An Update and Overview


Over the last 3 years there have been notable developments in the screening and treatment of perinatal depression. Most importantly, the DSM-V has made only minor changes in the diagnostic criteria for perinatal depression as compared to the DSM-IV; “perinatal,” as opposed to “postpartum,” is a specifier for depression with a requirement that the depression onset occurs during pregnancy or the first 4 weeks postpartum. Advances in the treatment of perinatal depression have been made over the last 3 years, including both prevention and acute interventions. Additional support has emerged confirming the primary risk factors for perinatal depression: a personal or family history, low SES and poor interpersonal support. There is general agreement that universal screening be conducted for all perinatal women, by both the woman’s obstetrician and the baby’s pediatrician.

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  1. 1.

    The two-item screen “have you felt down, depressed, or hopeless” and “have you lost interest or pleasure in things” does not have well-established sensitivity and specificity metrics. It also lacks utility as a clinical screening instrument because it does not screen for infrequent but potentially life-threatening thoughts such as self-harm or thoughts of harming the baby.

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    The three-item Prams screen includes the items: “I have felt down, depressed, or sad,” “I have felt hopeless,” and “I have felt slowed down physically” rated on a 1-5 scale from never to always.

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    Please see Deligiannidis and Freeman (2014) “Complementary and alternative treatments for perinatal depression” for a detailed description of these therapies [45]. Deligiannidis, K.M. and M.P. Freeman, Complementary and alternative medicine therapies for perinatal depression. Best Practice Research in Clinical Obstetrics and Gynaecology, 2014. 28(1): p. 85-95.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Kaela Stuart-Parrigon declares no conflict of interest.

Scott Stuart has received a grant from the National Institute of Heath.

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Correspondence to Scott Stuart.

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This article is part of the Topical Collection on Psychiatry in Primary Care

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Stuart-Parrigon, K., Stuart, S. Perinatal Depression: An Update and Overview. Curr Psychiatry Rep 16, 468 (2014).

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  • Perinatal
  • Depression
  • Review
  • Prenatal
  • Postpartum
  • Medication
  • Screening
  • Treatment