Putting Prevention into Practice
An Evidence-Based Approach
Interventions to Prevent Perinatal Depression
Am Fam Physician. 2019 Sep 15;100(6):365-366.
Author disclosure: No relevant financial affiliations.
A 25-year-old woman presents to your office after having recently missed her period. A urine pregnancy test confirms that she is pregnant. She takes acyclovir for suppression of genital herpes, which she acquired as a teenager. She reports a history of depression and sexual abuse during adolescence. She states that her mood has been fine lately and that she is no longer taking an antidepressant.
Case Study Questions
1. Based on the U.S. Preventive Services Task Force (USPSTF) recommendation statement, which one of the following is the most appropriate course of action to prevent perinatal depression in this patient?
A. Encourage regular physical activity.
B. Prescribe an antidepressant (e.g., sertraline [Zoloft], nortriptyline [Pamelor]).
C. Prescribe an omega-3 fatty acid supplement.
D. Provide counseling or refer to counseling.
E. Monitor the patient for depression symptoms.
2. According to the USPSTF recommendation, which additional risk factors, if present in this patient, would increase the risk of perinatal depression?
A. Personal or family history of depression.
B. Specific socioeconomic risk factors (e.g., low income, adolescent or single parenthood).
C. First-time pregnancy.
D. Recent intimate partner violence.
3. Which one of the following statements accurately summarizes the USPSTF recommendation regarding implementation of interventions to prevent perinatal depression?
A. There are no data on the ideal timing for offering counseling or referral to counseling interventions.
B. Screening for risk factors for perinatal depression should begin during the second trimester.
C. Counseling interventions should be provided only by licensed psychologists.
D. Group counseling is ineffective.
E. Accurate screening tools are available for identifying women who are at risk of perinatal depression and who might benefit from preventive interventions.
1. The correct answer is D. The USPSTF recommends that physicians provide counseling or refer to counseling pregnant and
1. Curry SJ, Krist AH, Owens DK, et al. Interventions to prevent perinatal depression: US Preventive Services Task Force recommendation statement. JAMA. 2019;321(6):580–587.
2. O'Connor E, Senger CA, Henninger M, et al. Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2019;321(6):588–601.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/perinatal-depression-preventive-interventions.
This series is coordinated by Kenny Lin, MD, MPH, Deputy Editor.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
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