Clinical Tools for Your Practice

6Important Note:

The PPSC documents and PDFs are copyrighted by The Postpartum Stress Center, LLC. All materials are intended solely for the personal use of the individual user and not to be disseminated broadly. Any assessment listed below that does not belong to the PPSC is given proper attribution.

BEFORE YOU SCREEN

Screening tools are only as good as how they are presented and received. If screening is not offered in an empathetic manner, you cannot expect to get candid responses. Do you feel prepared to confront a woman suffering from symptoms of depression and anxiety? Here are some questions to consider.
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ARE YOU ASKING THE RIGHT QUESTIONS?

This is a short list of assessment questions that should be asked of every single postpartum woman regardless of her clinical presentation. It has been our experience that postpartum women who feel particularly vulnerable are least likely to express their concerns about how they are feeling. This is why it is imperative to ask the right questions in order to accurately assess the degree to which her symptoms may be interfering with her life. While many women who struggle with symptoms of PPD may try desperately to present themselves as together and in control, they often secretly embrace the hope that someone will ask the right questions, recognize how bad they are feeling and reassure them that treatment is available. If you do not ask every single postpartum woman if she is having suicidal thoughts, you have no idea whether she is having thoughts of hurting herself or not.
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THE EDINBURGH POSTNATAL DEPRESSION SCALE (EPDS)

It has been recommended that healthcare professionals working with the perinatal population use the EPDS as an integral part of their assessment for depression. This is a 10-item, assessment tool that is valid and reliable for detecting postpartum depression.   This screening tool is user-friendly, easy to administer and easy to score. A score of 10-12 is considered the cut off for PPD and should be referred for further evaluation or treatment.  Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150:782-786 .
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THE POSTPARTUM DISTRESS MEASURE (PDM)*

“Previous measures of postpartum distress have focused on depressed mood despite evidence that postpartum anxiety is just as prevalent. The purpose of this study was to develop a new, brief screening measure to identify postpartum distress, defined as symptoms of depression and anxiety.”  Note: The PDM scale has not yet been validated. Clinicians are free to use it to get a sense of a constellation of symptoms.
*Kelly C. Allison, Amy Wenzel, Karen Kleiman, and David B. Sarwer. Journal of Women’s Health. April 2011, 20(4): 617-623.
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PERINATAL ANXIETY SCREENING SCALE (PASS)

The Perinatal Anxiety Screening Scale: development and preliminary validation. Archives of Women’s Mental
Health, DOI: 10.1007/s00737-014-0425-8
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PERINATAL SCARY THOUGHTS ALGORITHM (PPSC)

These steps provide a general guideline for actions to be taken when a perinatal client presents with thoughts that are scaring her. Please proceed with careful attention to her affective response to her thoughts.
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INTRUSIVE DIAGNOSTIC DISTRESS DIFFERENTIAL (PPSC)

Perinatal specialists wrestle with overlapping clinical presentations and key markers for differentiation. It seems that levels of distress can provide distinct diagnostic characteristics that can shape the course of intervention and treatment. This is particularly true when it comes to postpartum anxiety that manifests as instrusive thoughts. While these are not mutually exclusive and diagnostic lines are often blurred, we have listed some of the common presentations with an associated distress index. Due to the nature of any mental health issue, these categories are not discreet and may manifest with unique inconsistencies in any one individual.
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THE PPSC SUICIDE ASSESSMENT (PPSC)

Clinicians administering the Edinburgh Screen need to continue with follow-up questions for all patients who answer #10 with a 1, 2 or 3. (Please check out “PPD Safety Assessment: Identifying Patients at High Risk for Psychosis, Suicide, and Homicide” presented by Margaret G. Spinelli, RN, MD which inspired this assessment)
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EMERGENCY ROOM SCREENING FOR PSYCHOSIS (PPSC)

We have discovered that postpartum women in crisis are often met with healthcare workers who fail to recognize the urgency of the situation. We hope this fact sheet will offer guidance so postpartum women suffering with psychotic symptoms can receive immediate and appropriate intervention.
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RISK ASSESSMENT DURING PREGNANCY (PPSC)

This assessment is not diagnostic. Risk factors do not cause postpartum depression. Our intention is to help you become aware of the factors that can potentially make you vulnerable to depression, so you can mobilize your support network and make use of the resources available to you. The list below are factors that can increase your susceptibility to depression. Check all that apply and discuss the results with your doctor..read more…orDownload PDF

PATIENT INFORMATION SHEET

You are free to download the PPSC Patient Information Sheet for your personal use as long as 1) Credit is given to The Postpartum Stress Center, 2) No changes are made, and 3) No fee is charged.
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