PRESS RELEASE

Scottish mothers and families are set to benefit from a new treatment guideline on postnatal depression (PND), which will be launched in Glasgow today¹.

The guideline² was developed by SIGN³, an independent group of clinical experts and patient representatives, to provide clinical staff in Scotland with advice, based on a review of the latest evidence, on the treatment of PND - a condition which effects 10-15% of women who give birth in Scotland every year and which, if untreated, can have a prolonged and damaging effect on the relationship between mother and baby, and a detrimental effect on the child's psychological, social and educational development. (The guideline also provides advice on treating puerperal psychosis, a serious, but more rare, illness affecting one in 500 women after childbirth).

Evidence clearly shows that postnatal depression can be treated successfully yet in Scotland a significant number of women either fail to seek help, or fail to receive adequate treatment once PND has been diagnosed. Delays in seeking help often occur due to the stigma or shame felt by sufferers who can experience intense feelings of guilt, failure and inadequacy. Women may also fear that they will be viewed as "bad mothers" or that their baby may be taken away if they admit to feeling depressed. If these delays in seeking help occur, or sufferers do not seek help at all, the effects for mothers, babies and families can be great.

In order to improve this situation SIGN reviewed all of the published evidence in this area and also carried out a survey of all Scottish Health Boards and Trusts in order to ascertain what support was offered across Scotland to sufferers of PND and puerperal psychosis.

The new guideline, to be published today, provides clear guidance on -

• Early diagnosis, screening and prevention;
• Management of postnatal depression and puerperal psychosis, following diagnosis;
• Prescribing issues during pregnancy and breastfeeding;
• Information to be discussed with patients;
• Resources required to implement the guideline and reduce regional variation in service provision; and
• Over 20 areas in which further research is required

Dr Roch Cantwell, Consultant Psychiatrist and a Member of the SIGN Postnatal Depression Group, said,

"It is clear from our review of the evidence and survey of service provision that there is still much to be done to improve the level of treatment provided to, and to reduce the suffering of, mothers with postnatal depression and puerperal psychosis. We now have clear evidence to show that these illnesses can be treated successfully, and if not treated that there can be a detrimental effect on both mother and baby, yet our diagnosis and treatment is slow and the support available is variable across Scotland. Additionally, we have no dedicated facilities in Scotland to accommodate the most severely ill mothers who need admission to hospital along with their babies, and we are missing opportunities to prevent illness arising in the first place by more effective screening"

Dr Cantwell added,

"What we have to do is to find a means of bringing about a cultural change in thinking in Scotland which will de-stigmatise postnatal mental illness. Sufferers have to be made to feel confident enough to ask for help without fear of judgement by society. We have to de-mystify treatments which will help sufferers and also to ensure that patients can access these services wherever they live in Scotland. It is hoped that this guideline will provide the catalyst for this change".

ENDS

Contact: Graeme McAlister, Communications Manager or
Gail Crosbie (Communications Officer)
on 0131-247-3693 or 07808-939395

Notes for Editors

1. The Clinical Launch of the Postnatal Depression Guideline will take place at the Royal College of Physicians and Surgeons of Glasgow, 232-242 St. Vincent Street, Glasgow on 20 June 2002 (1.00 - 4.00pm). Short presentations, followed by question and answer sessions, covering a variety of perspectives (patient, public health, maternity services, psychiatric services and the voluntary sector) will be given.

Any member of the media wishing to attend should contact Graeme McAlister or Susan Laurence on 0131-247-3693 to arrange attendance, as spaces are strictly limited due to the demand from the NHS to attend this event.

2. 'Postnatal Depression and Puerperal Psychosis: A National Clinical Guideline', SIGN 60, Scottish Intercollegiate Guidelines Network, June 2002.

3. The Scottish Intercollegiate Guidelines Network (SIGN) is a collaborative network of health professionals and patient organisations, funded by the Clinical Resource and Audit Group (CRAG) of the Scottish Executive, to develop evidence-based clinical guidelines for the NHS in Scotland. It was established by the Medical Royal Colleges in 1993 and includes representatives from all the medical specialties, dentistry, nursing, professions allied to medicine, pharmacy, health service managers, social workers and patients.

SIGN has now developed and published 60 guidelines covering clinical areas including - asthma, diabetes, primary and secondary prevention of coronary heart disease, breast cancer, lung cancer, chlamydia, attention deficit hyperkinetic disorder and early rheumatoid arthritis, to name but a few. SIGN guidelines are now used internationally and SIGN is currently working closely with a variety of international guideline developers, including the World Health Organisation (WHO).

All SIGN guidelines can be downloaded free of charge from the SIGN website at www.sign.ac.uk