Issue 1/2026
Geneva – Mihaylova, R., Donkina, V.
National Center for Psychosomatics, Center for Psychoanalysis and Medicine, Nadezhda Hospital – Sofia
In general practice, the postpartum period is often the time when a mother’s mental health difficulties begin to manifest clearly, yet they are rarely recognized as clinically significant. Symptoms such as anxiety, low mood, insomnia, and emotional withdrawal are frequently interpreted as a “normal adjustment” to motherhood, which leads to missed
opportunities for early diagnosis of postpartum depression. When left unrecognized, the condition has a substantial
impact on the mother’s psychological functioning, the early mother–child bond, and family well-being, and is associated with long-term adverse consequences for the child [8,9]. In a number of European countries, mental health during the perinatal period is integrated into national health strategies and clinical algorithms, whereas in Bulgaria there is a lack of a systematic model for early recognition and coordination between inpatient and outpatient care. The present article examines the role of the hospital setting as a key point for screening and early intervention in postpartum depression and presents a practical methodology that can support the work of general practitioners through clear referral pathways, follow-up, and multidisciplinary collaboration.
Key words: postpartum depression; perinatal depression; EPDS; screening; hospital setting
Address for correspondence:
Geneva – Mihaylova, R.
National Center for Psychosomatics,
53A, „G. S. Rakovsky“, Blvd.
1000, Sofia