Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. 207-216 (doi:10.1542/peds.2005-2346)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (11)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Olson, A. L.
Right arrow Articles by Hurley, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Olson, A. L.
Right arrow Articles by Hurley, J.
Related Collections
Right arrow Office Practice

Brief Maternal Depression Screening at Well-Child Visits

Ardis L. Olson, MDa,b, Allen J. Dietrich, MDb, Greg Prazar, MDa and James Hurley, MDa

a Pediatrics
b Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire

OBJECTIVES. The goals were (1) to determine the feasibility and yield of maternal depression screening during all well-child visits, (2) to understand how pediatricians and mothers respond to depression screening information, and (3) to assess the time required for discussion of screening results.

METHODS. Implementation of brief depression screening of mothers at well-child visits for children of all ages was studied in 3 rural pediatric practices. Two screening trials introduced screening (1 month) and then determined whether screening could be sustained (6 months). Screening used the 2-question Patient Health Questionnaire. Practices tracked the proportions of visits screened and provided data about the screening process.

RESULTS. Practices were able to screen in the majority of well-child visits (74% in trial 1 and 67% in trial 2). Of 1398 mothers screened, 17% had 1 of the depressive symptoms and 6% (n = 88) scored as being at risk for a major depressive disorder. During discussion, 5.7% of all mothers thought they might be depressed and 4.7% thought they were stressed but not depressed. Pediatric clinicians intervened with 62.4% of mothers who screened positive and 38.2% of mothers with lesser symptoms. Pediatrician actions included discussion of the impact on the child, a follow-up visit or call, and referral to an adult primary care provider, a mental health clinician, or community supports. Pediatrician time needed to discuss screening results decreased in the second trial. Prolonged discussion time was uncommon (5–10 minutes in 3% of all well-child visits and >10 minutes in 2%).

CONCLUSIONS. Routine, brief, maternal depression screening conducted during well-child visits was feasible and detected mothers who were willing to discuss depression and stress issues with their pediatrician. The discussion after screening revealed additional mothers who felt depressed among those with lesser symptoms. The additional discussion time was usually brief and resulted in specific pediatrician actions.

Key Words: depression • maternal • primary care • screening

Abbreviations: EPDS—Edinburgh Postnatal Depression Scale • USPSTF—US Preventive Services Task Force • PHQ—Patient Health Questionnaire

Accepted Jan 20, 2006.




This article has been cited by other articles:


Home page
 PediatricsHome page
G. Caspary, D. M. Krol, S. Boulter, M. A. Keels, and G. Romano-Clarke
Perceptions of Oral Health Training and Attitudes Toward Performing Oral Health Screenings Among Graduating Pediatric Residents
Pediatrics, August 1, 2008; 122(2): e465 - e471.
[Abstract] [Full Text] [PDF]

Home page
 J Am Board Fam MedHome page
I. M. Bennett, A. Coco, J. C. Coyne, A. J. Mitchell, J. Nicholson, E. Johnson, M. Horst, and S. Ratcliffe
Efficiency of a Two-Item Pre-Screen to Reduce the Burden of Depression Screening in Pregnancy and Postpartum: An IMPLICIT Network Study
J Am Board Fam Med, July 1, 2008; 21(4): 317 - 325.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. Garg, A. M. Butz, P. H. Dworkin, R. A. Lewis, R. E. Thompson, and J. R. Serwint
Improving the Management of Family Psychosocial Problems at Low-Income Children's Well-Child Care Visits: The WE CARE Project
Pediatrics, September 1, 2007; 120(3): 547 - 558.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. J. Kemper, K. Kelleher, and A. L. Olson
Implementing Maternal Depression Screening
Pediatrics, August 1, 2007; 120(2): 448 - 449.
[Full Text] [PDF]

Home page
 PediatricsHome page
M. R. Sills, S. Shetterly, S. Xu, D. Magid, and A. Kempe
Association Between Parental Depression and Children's Health Care Use
Pediatrics, April 1, 2007; 119(4): e829 - e836.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
L. H. Chaudron, P. G. Szilagyi, A. T. Campbell, K. O. Mounts, and T. K. McInerny
Legal and Ethical Considerations: Risks and Benefits of Postpartum Depression Screening at Well-Child Visits
Pediatrics, January 1, 2007; 119(1): 123 - 128.
[Abstract] [Full Text] [PDF]