Peripartum Mood Disorders and Postpartum...

54
Peripartum Mood Disorders and Postpartum Depression Screening: For Primary Care Providers Caring for Children in Oregon

Transcript of Peripartum Mood Disorders and Postpartum...

Page 1: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Peripartum Mood Disorders and Postpartum Depression Screening:

For Primary Care Providers Caring for Children in Oregon

Page 2: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

A Project Of

The Oregon Pediatric Society

Oregon Chapter of the American Academy of Pediatrics (AAP)

Sponsored by:

Ford Family Foundation

Healthy Eastern Oregon Consortium Project

an OHA Community Prevention Grant

Multnomah Project LAUNCH

NW Newborn

Page 3: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

DISCLAIMER

The Oregon Pediatric Society (OPS), a Chapter of the

American Academy of Pediatrics, has no conflict of interest,

and is not affiliated with any other organization, vendor or

company.

Reasonable attempts have been made to provide accurate

and complete information.

The practitioner or provider is responsible for use of this

educational material, and any information provided should

not be a substitution for the professional judgment of the

practitioner or provider.

Page 4: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

CME This event is a joint providership between Bay Area Hospital and the Oregon Pediatric Society. Bay Area Hospital’s Continuing Medical Education (CME) Program is accredited by the Oregon Medical Association to sponsor Category 1 medical education activities for physicians. As an accredited institution, Bay Area Hospital’s Medical Education Committee designates this live educational activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™ Physicians should only claim credit commensurate with the extent of their participation in the activity. Bay Area Hospital fully complies with the legal requirements of the ADA and the rules and regulations thereof. If any participant in this educational activity is in need of accommodation, please call 503-334-1591, x101.

OPS Trainers and planners of these events have disclosed they have no financial relationship with a commercial entity producing health-care related products or services.

Page 5: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

• IMPROVE postpartum depression screening

in pediatric practices

• ENHANCE provider understanding, utilization,

and implementation of standardized screening

tools

• EDUCATE providers in proper documentation,

coding, and billing of screening tools

• BUILD provider awareness of local community

resources for evaluation and intervention

Goals & Objectives START BASIC

Page 6: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

AGENDA

1: POSTPARTUM DEPRESSION AND ANXIETY:

The Science Behind It & Recommended,

Standardized Tools

2: COMMUNITY RESOURCES

3: IMPLEMENTING STANDARDIZED SCREENING

In Your Practice

Adjourn

Page 7: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

The Science & Tools OF POSTPARTUM DEPRESSION

& ANXIETY SCREENING

PART 1

Page 8: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

• Primary care providers for children see moms early

and often.

• Mom’s and father’s mental health affects well-being

of baby and family.

• Child’s developmental health is directly influenced

by early relationship history.

• Screening new moms for depression can prevent a

host of childhood problems.

Importance of Screening WHY SCREEN MOM DURING WELL-CHILD VISITS?

Page 9: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Oregon by the Numbers

of women reported that they were

depressed during and/or after

pregnancy.

of those women were still depressed

when their child was 2 years old.

of adults in Oregon meet the criteria

for current depression.

24%

48%

7-8%

Page 10: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

PRAMS: PREGNANCY RISK ASSESSMENT MONITORING

SYSTEM

Demographic characteristics significantly associated with postpartum depression were:

•Young maternal age (13.4 % point variance youngest and oldest mothers)

•Single marital status (9.7% greater)

•Maternal education (13.6% difference)

•Medicaid recipient (11% greater)

•Race/Ethnicity showed lower risk for non-hispanic white compared to other groups.

Page 11: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Behaviors of Depressed Mothers

REDUCED

EMOTIONAL

RANGE

REDUCED

CARE OF

BABY

LESS RESPONSIVE TO BABY’S CUES AND NEEDS

LESS LIKELY TO OBTAIN PREVENTIVE

HEALTHCARE FOR BABY

LESS EMPATHY AND INTERACTIVE BEHAVIOR

Page 12: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

PHYSIOLOGIC

IMPACT DUE TO PERINATAL MOOD DISORDERS

Increased incidence of premature labor

Increased incidence of low birth weight

Hypertension

Increased cortisol response in infants

Increased incidence of drug and alcohol use

Page 13: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Maternal Depression

ANXIETY AFFECTS INFANTS

Decreased cognitive stimulation and

bonding may cause:

•Irritability

•Lower activity level

•Irregular sleep and feeding behaviors

•Impeded growth during first year of life

•Lifelong decreased ability to handle stress

•Difficulty in developing trusting relationships

•Increased depression, anxiety, and attention deficit

Page 14: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

The Still Face Experiment

Copyright © 2007 ZERO TO THREE http://www.zerotothree.org

Ed Tronick (http://www.umb.edu/Why_UMass/Ed_Tronick), director of UMass Boston's new Infant-Parent Mental

Health Program

Page 15: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

MIRROR NEURONS

Interaction through

relationships

builds the

foundation of brain

development and

social emotional

capacity.

Bruce Perry, Ph.D

Page 16: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

RISK FACTORS For Postpartum Depression & Anxiety

POVERTY

SUBSTANCE ABUSE

SLEEP DEPRIVATION

IMMIGRANT STATUS

DOMESTIC VIOLENCE

YOUNG MATERNAL AGE

TRAUMATIC EXPERIENCES

PREGNANCY COMPLICATIONS

HISTORY OF FAMILY DEPRESSION

Page 17: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

PROTECTIVE FACTORS Against Poor Outcomes

Breastfeeding

Child’s disposition

Routine health events

Familial warmth and cohesiveness

Support from other family members and community

Page 18: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

OVERVIEW OF MATERNAL MOOD DISORDERS

Maternal

Mood Disorders

“Baby Blues” Postpartum

Depression

Postpartum

Psychosis

Usually resolves

without treatment

Requires

treatment

Immediate treatment,

may require

hospitalization

10-25% 50-80% <1%

Page 19: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

BABY BLUES

• Normal condition in postpartum mothers

• Occurs in 50-80% of new mothers

• Symptoms include feelings of loss, anxiety, confusion, fear, or being overwhelmed

• Symptoms peak ~5 days after birth and resolve within a few weeks

• Does not disrupt function or daily routines

Page 20: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Symptoms of Postpartum Depression & Anxiety

(same DSM-5 criteria as major depression)

Lack of interest in baby, friends or family

Decreased energy and concentration

Thoughts of harming self or child

Feelings of being a bad mother

Changes in appetite and weight

Feeling “blue” and crying

Anger and irritability

Anxiety and worry

Sleep problems

Page 21: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Postpartum Depression and Postpartum

Anxiety (PPD and PPA)

• 10-25% of childbearing women affected.

• Many women are unable to recognize

symptoms of PPD.

• Negative effects on infant behavior and

development.

• Up to 50% of partners develop PPD, if

mother is symptomatic.

• Occurs any time during first 12 months

postpartum.

• Symptoms persist in half of untreated mothers one year postpartum.

• Symptoms last from 2 weeks to more than a year.

Page 22: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Postpartum Psychosis

• Relatively uncommon (1-3 out of 1000 women)

• Onset as early as one day after delivery, through baby’s first year

• Peak incident of onset is within first month

• Onset may be abrupt

• Characterized by hallucinations, paranoia, possible suicidal/infanticidal thoughts

• Requires immediate treatment and possible hospitalization

Page 23: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Primary Prevention Model

Risk factors are known

Problem is common

Population is known and present

Identifying high-risk mothers by screening is

inexpensive

Screening is also educational

Many risk factors are amenable to change

Screening leads to appropriate and timely referral

Page 24: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Summary and Conclusions Postpartum depression & anxiety:

Is a clinically significant illness that may have

long-lasting effects on the well-being of the

mother and her family

Distinct from “baby blues,” a normative

condition that resolves within a few weeks

following birth

Is treatable and can be easily screened during

well-child visits and routine checkups

Page 25: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

CAN prevent long-term

negative consequences for

infants

Assessment, Treatment &

Support

Page 26: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

When to Screen

Screen all mothers

Per ABCD Academy Recommendations:

2 weeks and repeat 2 – 4 months

Bright Futures recommendations not set

Subsequent screening as needed throughout child’s

first year of life

Page 27: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Maternal Depression

Screening Tools

• Patient Health Questionnaire

(PHQ-2) can be used as pre-

screener

• Edinburgh Postnatal

Depression Scale (EPDS) is

more thorough and includes

safety assessment

Page 28: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Recommended Schedule for

Standardized Screening

Developmental

Screening (AAP 2006)

9 months

ASQ/PEDS

18 months

ASQ/PEDS

&

M-CHAT R/F

24/30 mo.

ASQ/PEDS

&

M-CHAT R/F

3-5 years

ASQ/PEDS

as

needed

Maternal

Depression

Screening**

(Earls, et.al. 2010)

2 weeks

Edinburgh

2 months

Edinburgh

4 months

as needed

6 mo./

1 yr.

as

needed

Social-Emotional

Screening

Recommendations Pending

Page 29: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Patient Health Questionnaire (PHQ-2)

A brief two-item standardized

tool that screens for parental

depression, to be followed up

with a more comprehensive

screening or in-person

evaluation.

Page 30: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

PHQ-2 Scoring Less than one minute; self administered or done through

interview

• Over the past two weeks how often have you had little

interest or pleasure in doing things?

• Over the past two weeks how often have you been feeling

down, depressed, or hopeless?

Answers range 0-3:

0 = Not at all

1 = Several days

2 = More than half the days

3 = Nearly every day

USE

SECONDARY

SCREEN IF

SCORE IS

GREATER THAN

3.

Page 31: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

The Edinburgh Postnatal

Depression Scale (EPDS) A 10-item Self-Report Questionnaire

• Identifies depressive symptoms in pregnant women/new mothers

• Validated cross-culturally

• Available in 21 languages (Cox & Holden)

• Can be used throughout the first first

• At a mean of 12 weeks postpartum, the EPDS had a sensitivity of 100% and specificity of 90% for major depression with a cutoff score of 10

Page 32: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Any patient who scores > 0 on question #10

(“The thought of harming myself has occurred to me”) requires a

discussion about potential for immediate harm and referral to:

Mental Health Crisis Hotline

QMHP for Mental Health Evaluation/Services

If imminent self-harm is a concern, patient should not be left

alone and should be immediately referred or escorted to

Emergency Room.

Using EPDS to

DETERMINE RISK OF HARM

Page 33: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Edinburgh Postnatal Depression Scale

Example: Ima Blue

•EPDS Screening Tool

•EPDS instructions for administering and scoring

“Tool Time”: 2 Minutes

•Score Ima’s screening tool

•Interpret results

Page 34: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

EPDS Scoring

Response categories are scored: 0, 1, 2, and 3

Items marked with asterisk (*)

are reverse scored: 3, 2, 1, and 0

Add all scores for each of the 10 items

for the total score

Cutoff score is 10

Page 35: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Ima’s Score 1. I have been able to laugh and see the funny side of things. 1

2. I have looked forward with enjoyment to things 1

3. * I have blamed myself unnecessarily when things went wrong. 1

4. I have been anxious or worried for no good reason. 2

5. * I have felt scared or panicky for not very good reason. 1

6. * Things have been getting on top of me. 2

7. * I have been so unhappy that I have had difficulty sleeping. 2

8. * I have felt sad or miserable. 2

9. * I have been so unhappy that I have been crying. 2

10. * The thought of harming myself has occurred to me. 0

TOTAL 14

Page 36: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Discussing Screening Results

• Recognize sensitivity of issue

• Reinforce how mother’s health impacts her child without increasing/promoting feelings of guilt or shame

• Provide a supportive, non-judgmental environment

• Consider cultural attitudes toward depression and screening

Page 37: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

INCREASE awareness & recognition

REFER parent to OB or parent’s primary care

provider (if you aren’t already that person)

DISCUSS problem with mother’s PCP

FOLLOW UP with mother and infant sooner than

next typical visit

OFFER mental health and community resources

for parent

The Role of the Provider

Page 38: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Options for Support and Treatment

Self Care

Social Support

Mental Health Referral

Medication

Page 39: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Self Care for PPD

Encourage simple changes for mother

• A well-balanced diet

• Exercise

• Good sleep habits

• Stress management

• Relaxation techniques

Suggested Resource:

Patient Guide – Self-care program for Women with PPD and Anxiety (http://www.bcapop.ca/uploads/9/9/0/1/9901389/reproductivementalhealthselfcareguide.pdf)

Page 40: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Antidepressant Use During

Pregnancy and Breastfeeding

SERTRALINE and FLUOXETINE

• Both are Pregnancy category C & Lactation

category L2

• Risk of non treatment needs to be considered

Believed to be safest:

Page 41: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Meds in Pregnancy & Lactation

Resources & Consultation

LactMed: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

Mass General Women’s Health: http://www.womensmentalhealth.org/specialty-clinics/breastfeeding-and-psychiatric-medication/

UIC Perinatal Psych Project (Healthcare Provider Consultation Line): 800-573-6121 www.psych.uic.edu/research/perinatalmentalhealth/consultation

OTIS: 866-626-OTIS (6847) www.Otispregnancy.org

MOTHERISK: 877-439-2744 www.motherisk.org/prof/drugs.jsp

Page 42: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Procedure Codes

99420 - Administration and interpretation of health

risk assessment instrument

Pair with ICD-9 V20.2 if screen normal or 648.42 if

abnormal (mental disorders complicating pregnancy

childbirth or the puerperium)

V79.8 - Special screening for other specified mental

disorders and developmental handicaps

V61.8 – labeled as screening for maternal

depression

Page 43: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Community PARTNERS & RESOURCES

PART 2

Page 44: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

• Oregon Maternal Mental Health Website

www.healthoregon.org/perinatalmentalhealth

Information and links to services of Oregon women, families and providers

• Postpartum Support International (PSI)

www.postpartum.net or 1-800-944-4PPD

English and Spanish telephone helpline for support and resources

• 211info

Email [email protected] or text zip code to 898211 or Dial 2-1-1

Free guidance, information and referral

• Full House Moms

http://www.fullhousemoms.com/

Support group for parents of multiples

• Brief Encounters

http://www.briefencounters.org/bewp/

Support group for parents of pregnancy loss or infant loss

• National Suicide Prevention

www.suicidepreventionlifeline.org or 1-800-273-8255

24 hour Lifeline

COMMUNITY RESOURCES & LOCAL SUPPORT

Page 45: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Implementing STANDARDIZED SCREENING

IN YOUR PRACTICE

PART 3

Page 46: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Getting STARTed with Screening Tools Small Steps…

QUESTIONS:

• How do you make time for screening?

• Who administers the screening, scores

the tests, and communicates results?

• Who else needs to be involved in the

screening and referral process?

Page 47: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Improvement Methods (from IHI)

What are we trying to accomplish?

How will we know that a change is

an improvement?

What changes can we make that

will result in improvement?

Plan

Do Study

Act

Page 48: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Meet objective Develop questions & predictions (why) Create plan to carry out the cycle (who, what, where, when)

Plan

Do

Act

Study

The PDSA Cycle

Carry out the plan Document problems and unexpected observations Begin analysis of the data

What changes are to be made?

Next cycle?

Complete the analysis of the data

Compare data to

predictions

Summarize what was learned

Page 49: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Continuous PDSA Cycles

ACT

STUDY

PLAN

DO

ACT

STUDY

PLAN

DO

ACT

STUDY

PLAN

DO

Hunches,

theories,

ideas

Changes that

result in

improvement

Page 50: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

ADDITIONAL INFORMATION

PART 4

Page 51: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

CME Information

• This START training is eligible for a

maximum of 1.0 hours AMA PRA

Category 1 Credit(s)™

• You will receive a START CME completion

certificate via email when you complete

the follow-up survey

Page 52: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Other START Training Modules

ACEs/Trauma-Informed Care

Adolescent Depression Screening

Adolescent SBIRT with CRAFFT

Autism Spectrum Disorders (ASD) 101

Basic Developmental Screening

Behavioral Health Integration

To schedule a training, please contact Peg King, START Program Manager

[email protected] 503-334-1591 x101

Page 53: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

To find out more about the

Oregon Pediatric Society

please visit:

www.oraap.org

Page 54: Peripartum Mood Disorders and Postpartum …oregonstart.org/wp-content/...Depression-Screening-Training-Slides.pdfPeripartum Mood Disorders and Postpartum Depression Screening: ...

Thank you.