Magazine article Clinical Psychiatry News

Insurers Survey New Mothers about PPD. (Edinburgh Postnatal Depression Scale Used)

Magazine article Clinical Psychiatry News

Insurers Survey New Mothers about PPD. (Edinburgh Postnatal Depression Scale Used)

Article excerpt

Experts disagree on whether a postpartum depression screening program started by several health insurers is a good way to reach patients who may be suffering from the condition.

Approximately 20 health plans, under a subcontract with mental health carve-out Magellan Behavioral Health in Columbia, Md., are sending out written questionnaires to new mothers in their plans. The mothers fill out the questionnaires and return them, and case managers at the plan score their answers. The case managers call any patients who screen positive for postpartum depression (PPD) to talk to them and see if they need further treatment from a social worker or psychiatrist.

Dr. Andrew Rudo, Magellan's senior vice president for medical services, said that the screening is a valuable service because PPD occurs in 10%-12% of new mothers. "So many people are unaware of it that it goes undetected and undertreated, and a lot of undue suffering could come from that."

Programs like this one "are an excellent idea because a lot of people don't know about PPD, and patients are unfamiliar with the symptoms," said Dr. Ruta Nonacs of the perinatal psychiatry program at Massachusetts General Hospital in Boston. Dr. Nonacs and her colleagues used a similar survey on 850 patients at her hospital's obstetrics clinic and found that approximately 10% suffered from depression after delivery. "The questionnaire helps focus on this problem and draws attention to it."

But Dr. Carol Bernstein of New York University, New York, said that the questionnaire could give some patients a false sense of security. "People's gut reaction is that if they don't check [all the boxes off], they're safe," she said. "And to think a social worker who is not a physician is going to add up the points and make a diagnosis is simply ridiculous. …

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