The effectiveness of psychosocial assessment in the detection and management of postpartum depression: a systematic review.

ABSTRACT

INTRODUCTION: Perinatal mental disorders remain a public health concern. A psychosocial assessment gives a comprehensive understanding of a woman's circumstances by identifying risk factors that affect the overall mental state and function of the woman. The aim was to evaluate the current international evidence regarding the effectiveness of psychosocial assessments in the detection and management of postpartum depression. EVIDENCE ACQUISITION Six health related databases were systematically searched from January 2000 to June 2016. Full papers reporting the effectiveness of psychosocial assessment on the detection and management of postpartum depression were included. A data extraction form was designed and piloted on two studies. Data were extracted on study design, population, study context, intervention/s and outcome/s. The methods of all the studies selected were critically appraised using the Quality Assessment Tool for Quantitative Studies. EVIDENCE SYNTHESIS: A total of 692 citations were found. Four randomized control trials (RCTs) met full inclusion criteria and qualified for full paper review and data extraction. Due to the heterogeneity of the data retrieved a narrative synthesis was carried out. Overall, when compared to routine care, psychosocial assessments were found to be sensitive to detect risk factors associated with postnatal depression. Results from two of the included studies reported no statistically significant difference in outcomes amongst those who screened positive and received the intervention compared to those who screened positive and were given standard care. CONCLUSIONS: Presently there is a paucity of published data on the effectiveness of psychosocial assessment in the detection and management of postnatal depression and results show conflicting evidence. Further RCTs are recommended to further elucidate the effectiveness of psychosocial assessments.