Depression screening during pregnancy.

Depression in the antepartum period is more commonly missed by clinicians than is intimate partner violence, although more women and families suffer from this debilitating disease. Early identification and appropriate psychotherapeutic interventions significantly reduce the risk of adverse effects for the mother, infant, and family. Despite debate regarding specificity and sensitivity, 2 instruments have been predominantly referenced for use in antepartum screening: the Edinburgh Postnatal Depression Scale and the Center for Epidemiologic Studies Depression Scale. Routine screening combined with interview methods provides high reliability for predicting a risk for depression in pregnancy and postpartum. Caution should be exercised when new onset is identified or when women who were using psychotropic medications before pregnancy are being treated, because the relative risk of prenatal exposure to medication is counterbalanced by the risk of relapse of maternal psychiatric disorders.