To screen or not to screen: Are we asking the right question? In response to considering de-implementation of universal perinatal depression screening

Rachel Vanderkruik; Marlene P Freeman; Ruta Nonacs; Michael Jellinek; Margaret L Gaw; Charlotte A Clifford; Stephen Bartels; Lee S Cohen

doi:10.1016/j.genhosppsych.2023.04.012

To screen or not to screen: Are we asking the right question? In response to considering de-implementation of universal perinatal depression screening

Gen Hosp Psychiatry. 2023 Jul-Aug:83:81-85. doi: 10.1016/j.genhosppsych.2023.04.012. Epub 2023 Apr 23.

Authors

Rachel Vanderkruik¹, Marlene P Freeman², Ruta Nonacs², Michael Jellinek³, Margaret L Gaw⁴, Charlotte A Clifford⁴, Stephen Bartels⁵, Lee S Cohen²

Affiliations

¹ Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, United States of America; Harvard Medical School, Boston, MA, USA. Electronic address: rvanderkruik@mgh.harvard.edu.
² Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, United States of America; Harvard Medical School, Boston, MA, USA.
³ Harvard Medical School, Boston, MA, USA.
⁴ Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, United States of America.
⁵ Harvard Medical School, Boston, MA, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.

PMID: 37141774
DOI: 10.1016/j.genhosppsych.2023.04.012

Abstract

This Editorial is a response to the Canadian Task Force on Preventive Health Care's recent recommendation "against instrument-based depression screening using a questionnaire with cut-off score to distinguish 'screen positive' and 'screen negative' administered to all individuals during pregnancy and the postpartum period (up to 1 year after childbirth)." While we acknowledge the gaps and limitations in research on perinatal mental health screening, we have concerns regarding the potential impact of a recommendation against screening and for "de-implementation" of existing perinatal depression screening practices, particularly if there is not careful attention to the specificity as well as limitations of the recommendation, or if there are not clear alternative systems put in place to support the detection of perinatal depression. In this manuscript, we highlight some of our key concerns and suggest considerations for perinatal mental health practitioners and researchers.

MeSH terms

Canada
Depression / diagnosis
Depression / prevention & control
Depression, Postpartum* / diagnosis
Depressive Disorder* / diagnosis
Female
Humans
Mass Screening
Pregnancy
Pregnancy Complications* / diagnosis
Pregnancy Complications* / psychology