Guideline No 60: Postnatal Depression and Puerperal Psychosis

Postnatal depression and puerperal psychosis
Section 7: Development of the guideline

7.1 Introduction

Sign is a collaborative network of clinicians, other health care professionals and patient organisations, funded by the Clinical Resource and Audit Group (CRAG) of the Scottish Executive Health Department. SIGN guidelines are developed by multidisciplinary groups using a standard methodology based on a systematic review of the evidence. Further details about SIGN and the guideline development methodology are contained in SIGN 50: A guideline developer's handbook.

7.2 The guideline development group

Mrs Patricia Purton, Chairman, Director, Royal College of Midwives Scottish Board, Edinburgh
Dr Roch Cantwell, Methodologist, Consultant Psychiatrist and Honorary Senior Lecturer, Gartnavel Royal Hospital, Glasgow
Professor Beth Alder, Director of Research, Faculty of Health and Life Sciences, Napier University
Dr Barbara Ballinger, Consultant Psychiatrist (retired), Dundee
Dr Roddy Campbell, Consultant Obstetrician and Gynaecologist, Borders General Hospital, Melrose
Ms Francesca Chappell, Information Officer, SIGN
Mr Robert Crawford, Community Psychiatric Nurse, Hawick
Ms Vivienne Dickinson, Project Manager, Church of Scotland Postnatal Depression Project, Edinburgh
Ms Tania Dignan, Patient Representative, Edinburgh
Ms Catriona Hendry, Lecturer in Midwifery, Glasgow Caledonian University
Dr Mary Hepburn, Consultant Obstetrician, Royal Maternity Hospital, Glasgow
Ms Liz Kearney, Health Visitor, Coatbridge
Dr Eilis Kennedy, Specialist Registrar, Child Psychiatry, Glasgow
Dr Gerry McPartlin, General Practitioner, Edinburgh
Ms Evelyn McPhail, Chief Pharmacist, Fife Primary Care NHS Trust
Ms Kim Milledge, Health Visitor, Fife Primary Care NHS Trust
Miss Christine Puckering, Senior Research Fellow, Child & Adolescent Psychiatry, Yorkhill Hospital, Glasgow
Mrs Marion Shawcross, Social Work Officer, Mental Welfare Commission for Scotland, Edinburgh
Dr Imogen Stephens, Consultant in Public Health Medicine, Argyll & Clyde NHS Board
Ms Joanne Topalian, Programme Manager, SIGN
Dr Sara Twaddle, Health Economist, Stobhill Hospital, Glasgow
Ms Jenny Williams, Health Visitor, Edinburgh
Mrs Noreen Wright, Patient Representative, Edinburgh

The membership of the guideline development group was confirmed following consultation with the member organisations of SIGN. Declarations of interests were made by all members of the guideline development group. Further details are available from the SIGN Executive.

7.3 Systematic literature review

Literature searches were initially conducted in Medline, Embase, Cinahl, PsychLit, Healthstar, and the Cochrane Library using the year range 1991-2000. The literature search was updated with new material during the course of the guideline development process. Key websites on the Internet were also used, such as the National Guidelines Clearinghouse and the Marcé Society. The literature search was then extended back to as far as was available in each of the databases and extra searches were supplied in areas such as complementary medicine and health economics. These searches were supplemented by the reference lists of relevant papers and group members' own files. A lack of good evidence was identified by the searches, these results are similar to those of the Cochrane Library. Overall, a total of 3,900 abstracts were identified by the literature searches, over 300 papers were assessed resulting in the final reference list of 171 papers.

7.4 Consultation and peer review

A national open meeting is the main consultative phase of SIGN guideline development, at which the guideline development group present their draft recommendations for the first time. The national open meeting for this guideline was held in June 2001 and was attended by all of the key specialties relevant to the guideline. The draft guideline was also available on the SIGN web site for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline.

The guideline was reviewed in draft form by a panel of independent expert referees, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence base supporting the recommendations in the guideline. SIGN is grateful to all of these experts for their contributions to this guideline.

Ms Cheryll Adams, Professional Officer, Community Practitioners' and Health Visitors Association
Dr Mac Armstrong, Chief Medical Officer, Scottish Executive
Dr James Beattie, General Practitioner, Inverurie
Professor Ian Brockington, Professor of Psychiatry, University of Birmingham
Ms Cynthia Clarkson, UK Trustee, National Childbirth Trust, Edinburgh
Ms Asha Day, Director of Diversity, East Midlands Work Force Confederation
Ms Patricia Dawson, Head of Policy, Royal College of Nursing, Edinburgh
Ms Lesley Edwards, Community Psychiatric Nurse, West Calder Medical Practice
Dr Sandra Elliot, Senior Lecturer in Psychology, University of Greenwich, London
Dr Cathryn Glazener, Senior Clinical Research Fellow, Health Services Research Unit, Aberdeen University
Dr Annie Griffiths, General Practitioner, Inverness
Dr Margaret Hannah, Consultant in Public Health Medicine, Fife Health Board
Professor Dale Hay, Professor of Psychology, Cardiff University
Ms Jennifer Holden, Psychology Lecturer (retired), Edinburgh
Dr Moira Kennedy, General Practitioner, Wallacetown Health Centre, Dundee
Mr Martin Kettle, Area Services Manager, Possilpark Health Centre, Glasgow
Ms Ann Lees, Health Economist, Argyll and Clyde Acute Trust
Ms Joyce Linton, Practice and Policy Development Midwife, Cresswell Maternity Hospital, Dumfries
Dr John MacDonald, General Practitioner, Hawick
Dr Una McFadyen, Consultant Paediatrician, Stirling Royal Infirmary
Dr Patricia McEllarton, Teratologist, National Teratology Information Service, Newcastle
Professor John McLeod, Professor of Psychology, University of Abertay, Dundee
Dr Margaret Oates, Senior Lecturer in Psychiatry, University of Nottingham
Ms Nicola Ring, Nurse Co-ordinator, Scottish Clinical Effectiveness Programme
Ms Karen Robertson, Perinatal Nurse Consultant, Gartnavel Royal Hospital, Glasgow
Professor Debbie Sharp, Professor of Primary Health Care, University of Bristol
Ms Janet Trundle, Prescribing Advisor, Renfrewshire and Inverclyde Primary Care Trust
Dr Hugh Whyte, Primary Care Directorate, Scottish Executive
Dr Agnes Wood, General Practitioner, Penicuik

The guideline was then reviewed by an Editorial Group comprising relevant specialty representatives on SIGN Council, to ensure that the peer reviewers' comments had been addressed adequately and that any risk of bias in the guideline development process as a whole had been minimised. The Editorial Group for this guideline was as follows:

Dr Lesley Macdonald, Faculty of Public Health Medicine
Dr Adrian Lodge, Royal College of Psychiatrists
Professor Gordon Lowe, Chairman of SIGN
Ms Juliet Miller, Director of SIGN
Dr Gillian Penney, Royal College of Obstetrians and Gynaecologists
Dr Bill Reith, Royal College of General Practitioners
Ms Ruth Stark, British Association of Social Workers
Dr Bernice West, National Nursing, Midwifery and Health Visiting Advisory Committee
Dr Peter Wimpenny, Robert Gordon University, School of Nursing & Midwifery

7.5 Acknowledgements

SIGN is grateful to the following former members of the guideline development group and others who have contributed to the development of this guideline:

Ms Rhona Hotchkiss, Director, Nursing and Midwifery Practice Development Unit
Dr Iain Mathie, General Practitoner, Cairneyhill, Fife
Dr Alasdair Philp, Improving Mental Health Information Project Manager, NHSScotland Information and Statistics Division
Ms Anne Silcock, Health Visitor, Aboyne