Ask the Question: Screening for Postpartum Mood and Anxiety Disorders in Pediatric Primary Care.

Postpartum mood and anxiety disorders (PMADs) are a significant source of toxic stress for young children and can disrupt developing brain architecture resulting in long-lasting deleterious effects. Thus, screening for PMADs must be considered as an essential task of a pediatric primary care provider (PCP) and the pediatric medical home. Problems in parenting capacity in mothers with PMADs can lead to disorders in attachment and a range of other emotional and developmental challenges for a young child. Therefore, all PCP office visits with mothers should include surveillance as well as formal screening at regular, pre-determined intervals. During surveillance, identification of psychosocial, maternal, infant, and maternal/infant risk factors is critical. There are a number of well researched, standardized, reliable, free and valid screening tools including the Patient Health Questionnaires (PHQ-2 and PHQ-9) and the Edinburgh Postnatal Depression Scale (EDPS). Office implementation includes availability of educational materials, resource information, and referrals so families can get appropriate treatment. Screening for PMADs is highly effective and helps to identify a common, underdiagnosed disorder in parents that without identification and appropriate treatment can lead to significant negative outcomes for a young child.