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Womens Health Issues. 2008 Jan-Feb;18(1):44-52. doi: 10.1016/j.whi.2007.09.001.

Stepped care treatment of postpartum depression: a primary care-based management model.

Author information

  • 1Department of Family Medicine & Community Health, University of Minnesota, St. Paul, MN 55103, USA. dgjerdin@umphysicians.umn.edu

Abstract

BACKGROUND AND PURPOSE:

Postpartum depression (PPD), the most prevalent serious postpartum complication, is a devastating illness that negatively impacts not only the mother, but also her infant, other family members, and work performance. There is an extensive body of research addressing systems-based quality improvement efforts for treatment of depression in primary care populations; however, little of this research has been directed toward postpartum populations. This paper presents a health care systems-based quality improvement model for the treatment of PPD derived from research outcomes in general primary care populations.

METHODS:

OVID/MEDLINE and PsychINFO searches were performed using the following terms: depression, postpartum depression, mass screening, collaborative care, stepped care, psychotherapy, cognitive-behavioral therapy, interpersonal therapy, and education as keywords.

MAIN FINDINGS:

The PPD management model described herein includes screening and diagnosis, initiation of active treatment, and use of collaborative care, which includes primary care visits, case manager follow-up, and more intensive care, through specialty consultation or referral, for complicated or difficult cases.

CONCLUSION:

Stepped care, a form of collaborative depression treatment, is proposed as a practical, cost-effective method for improving PPD diagnosis and clinical outcomes.

PMID:
18215764
[PubMed - indexed for MEDLINE]
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