Research into Postnatal Depression at Clínic

Research into postnatal depression is conveyed through the Maternity and Mental Health (MATERSAM) line of research. Postnatal depression is the major path and the one that has received more funded projects.

Specific questionnaires have been validated for the detection of postnatal depression, like the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Bonding Questionnaire (PBQ) for the detection of alterations in the mother-baby relationship.

In collaboration with international perinatal mental teams, we have translated and participated in the design of the Semi-Structured Perinatal Mental Health Interview (Stafford Interview). Furthermore, a study has been made of the factors associated with presence of postnatal depression (perfectionism, depression during pregnancy, or a personal history, social-economic factors), the course of a depressive episode in the postnatal period (with longitudinal follow-ups and outcomes at two and eight years) with a duration of about one year, and it is known that 10% of the mothers had not recovered at two years.

It has also participated in demonstrating that one-third of the mothers with postnatal depression have difficulties and problems in the establishment and maintenance of the maternal bond, which requires an early and specialised intervention.

Ongoing Trials and Research Projects

Research into postnatal depression is currently focused on the impact of the type of depression and associated factors on the mother-child bond and the neurodevelopment of the baby.

It continues the line of the study of the pharmacokinetics and clinical safety of antidepressant psychotic drugs, by monitoring them during the pregnancy, delivery and lactation (fluoxetine, citalopram, escitalopram, chlorimipramine, and nortriptyline).

It is working on the consolidation of a new line of research on the predictive factors of decompensation in the postnatal period in those mothers with a previous history of Recurrent Depressive Disorder, Bipolar Disorder or Puerperal Psychosis.

The CLINIC–BCN Perinatal Mental Health Unit (USMP), forms part of the Stafford International Perinatal Working Group, coordinated by Prof. Ian Brockington. This group has bi-annual expert meetings in Perinatal Mental Health in order to debate and reach a consensus on new clinical practices.

It also forms part of the European Perinatal Depression COST Project for the communication and awareness of Perinatal Depression, with meetings and exchanges with international groups.

In 2018 the first Perinatal Mental Health from Clínic Group of the Integral Health Area of Barcelona Esquerra (GCSMP-AISBE) was created with the aim of establishing efficient coordination and referral circuits between the different teams of the area that attend to women in the perinatal period.

The USMP CLÍNIC-BCN acts as consultant to the Department of Health of the Catalonian Government on new actions in maternal mental health, such as the production of the latest edition of “Protocol del Seguiment de l’Embaràs a Catalunya” (Protocol of the Follow-Up of Pregnant Women in Catalonia), 3rd Edition It agreed to the incorporation of the mental health care of pregnant women and new mothers through an improvement in the information on their health, with the incorporation of personal and family mental health history and risk factors such as partner violence, as well as the detection of anxiety-depressive symptoms using the Whooley and EPDS questionnaires.

The active participation of the patients being treated has been encouraged by the USMP. In the past year it has created the Expert Mothers Program (MAREX) following the directives of the Expert Patient Program of the Catalonian Government Department of Health. The MAREX program has the objective of boosting the autonomy and joint responsibility of the mothers, to know and understand the importance of maternal mental health, to promote the detection and self-awareness of perinatal mental disorders and create support networks to eradicate stigmatising behaviours and beliefs (main topic in the organisation and participation on the event of the World Day for Maternal Mental Health of 2018).

In line with the strategic plan of the Hospital Clínic de Barcelona, Patient Participation Groups have been formed with the mothers treated in the Unit, in order to define and establish improvements in structural matters as well as functional ones. These groups will help to understand the practices of value, to dispense with some and incorporate those that improve the quality of care and are appreciated by the treated mothers.