Screening and treatment of postpartum depression across international guidelines: literature review

Abstract

Postpartum depression (PPD) is a significant and common mental health disorder affecting women during the perinatal period and has great implications for maternal and infant well-being. This literature review systemically examines international clinical practice guidelines for the screening and treatment of PPD, aiming to identify similarities and differences across international guidelines. A total 13 clinical guidelines from countries including the USA, Canada, Australia, and several European nations were analyzed, focusing on recommended screening tools, treatment modalities, and follow-up practices. This literature review involved a systematic search of clinical practice guidelines related to postpartum depression from various international sources, utilizing databases such as PubMed, Clinical Key, and Science Direct. The identification process followed a comprehensive search strategy, employing keywords and MeSH terms corresponding to the PICO framework (Population, Intervention, Comparison, Outcome). A total of 295 studies were initially identified, of which 13 clinical guidelines met the inclusion criteria based on strict guidelines that addressed screening, management, or treatment of postpartum depression, were written in English, and were available in full text. Data were extracted on relevant characteristics of the guidelines, including the country of origin, organization, and recommended practices for screening tools and treatment strategies. The review reveals a consensus among guidelines regarding the importance of early screening for PPD using validated tools such as the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9). Most guidelines recommend routine screening during the antenatal and postpartum periods, underscoring the critical window for intervention. Treatment recommendations emphasize the efficacy of cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) as first-line options for mild to moderate cases, with selective serotonin reuptake inhibitors (SSRIs) favored for moderate to severe conditions. Overall, while there exists broad agreement on the utilization of standardized screening tools and treatment approaches, the study underscores the need for harmonization of guidelines globally to improve PPD management and ensure equitable access to care for affected women.