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Developmental Screening for Perinatal Depression

 

When to screen: 1, 2, 4, and 6 month well-child visits

Although this domain is called Perinatal Depression, which often refers to a birthing person, it is important to screen parents and other caregivers in the household for depression during the first year of a child's life. We recommend the Safe Environment for Every Kid (SEEK), as it assesses depression through its inclusion of the Patient Health Questionnaire-2 (PHQ-2) items, as well as other concerns that may arise in the household. 

If a caregiver indicates experiences of depressed mood and inability to feel pleasure (positive for PHQ-2 or the PHQ-2 items within the SEEK), a self-report assessment of depression symptoms is recommended (and may be required by Managed Care Organizations or Private Insurers).  As such, we also recommend the Patient Health Questionnaire-9 as a follow-up to a positive PHQ-2 (independent or within SEEK), or as the initial screening tool for Perinatal Depression.

The Edinburgh Postnatal Depression Scale (EPDS) is now a recommended screening tool in the Louisiana Developmental Screening Guidelines to screen for Caregiver Depression. EPDS optimizes the early detection of Perinatal Mental Health Disorders and can accurately and efficiently screen caregivers in less than 5 minutes. The screens can also be reimbursed by Louisiana Medicaid.

Louisiana Medicaid reimburses for perinatal depression screens using code 96161. Please refer to the bulletin and fee schedule for more information.

 

 

 

 

 

 

Recommended Tool: Edinburgh Postnatal Depression Scale (EPDS)

  • Cost: No Cost
  • Languages Available: 18
  • Age Range: not age dependent
  • What is Assessed: frequency of depressed mood and anhedonia over the past 7 days
  • Time to Complete: less than 5 minutes
  • Time to Score: less than 3 minutes
  • Suggestions for When and Where: For use between 28 – 32 weeks in all pregnancies and 6 – 8 weeks postpartum for males and females. Given the sensitive nature of these questions, consider handing out in an exam room

 

Recommended Tool: Patient Health Questionnaire-2 (PHQ-2)

The questions used for this tool are embedded in the Brief Early Childhood Screening Assessment (Brief-ECSA) and Safe Environment for Every Kid (SEEK). 

  • Cost: No Cost
  • Languages Available: more than 20 
  • Age Range: not age dependent
  • What is Assessed: frequency of depressed mood and anhedonia over the past two weeks
  • Time to Complete: less than 2 minutes
  • Time to Score: less than 1 minute
  • Suggestions for When and Where: given the sensitive nature of these questions, consider handing out in an exam room
  • Training Video: Combined with PHQ-9 - see below!

 

Recommended Tool: Patient Health Questionnaire-9 (PHQ-9)

In addition to recommending the Patient Health Questionnaire-9 as an initial screening tool for Perinatal Depression, we also recommend using it as a follow-up to a positive PHQ-2 (independent or within SEEK).

  • Cost: No Cost
  • Languages Available: more than 50 
  • Age Range: not age dependent
  • What is Assessed: frequency of depression symptoms over the past two weeks
  • Time to Complete: less than 2 minutes
  • Time to Score: less than 1 minute
  • Suggestions for When and Where: given the sensitive nature of these questions, consider handing out in an exam room

 

Recommended Tool: Safe Environment for Every Kid (SEEK)

The PHQ-2 items are embedded in the SEEK, which is why the SEEK is also a recommended tool for perinatal depression.

  • Cost: SEEK has scaled fees based on the size of the practice. Review their license agreement here
  • Languages Available: English, Spanish (PQ-R), Chinese, Vietnamese 
  • Age Range: not age dependent
  • What is Assessed: parental depression, parental substance abuse, major parental stress, intimate partner violence, food insecurity, harsh punishment
  • Time to Complete: 5 minutes to complete
  • Time to Score: less than 3 minutes
  • Suggestions for When and Where: given the sensitive nature of these questions, consider handing out in an exam room


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