Thursday, April 11, 2019

Pregnant Women May Be Less Likely to Get Depression Treatment Than Other Women

More than half of pregnant women who are depressed may not get depression treatment, according to a study published Wednesday in Psychiatric Services in Advance.

The researchers analyzed results from the 2011-2016 National Survey on Drug Use and Health, zeroing in on the 12,360 women of reproductive age (18 to 44 years) who reported symptoms of a major depressive episode during the past year according to DSM-IV criteria. These women were asked whether there was a time during the past year when they needed mental health treatment or counseling but did not get it and, if so, why not. Researchers then compared the responses of women in the sample who were pregnant (3%) with those who were not (97%).

The researchers found that 51% of pregnant women and 43% of nonpregnant women with depression did not get treatment. Financial concerns, including the cost of the treatment, were cited by both groups of women as the primary reason for not receiving needed mental health treatment or counseling, according to study author Maria X. Sanmartin, Ph.D. (pictured above), an assistant professor at Hofstra University, and colleagues.

“It is surprising that 51% of pregnant women with major depressive episode did not receive any mental health treatment,” Sanmartin told Psychiatric News. “OB-GYNs should be asking about patients’ mental health status, raising patient awareness, and at least be offering patients the opportunity to receive mental health treatment.”

Sanmartin said pregnant women with a major depressive episode reported high prevalence of past-month substance use, including alcohol use (23%), marijuana use (17%), and misuse of prescription pain relievers (6%).

These are among the other findings reported in the study:

  • About 40% of pregnant women reported having an unmet need for mental health care treatment or counseling versus 34% of the nonpregnant women.
  • Financial concerns, including cost of care, were the most commonly cited reason among the women for not getting mental health care (22% of pregnant women versus 18% of nonpregnant women). Pregnant women with a depressive disorder were more likely to be low income, receive public insurance benefits, and were less likely to have a college degree.
  • Prescription medication was the most prevalent form of treatment among pregnant women (40%), despite treatment guidelines recommending evidence-based psychosocial interventions and contact with psychiatrists before initiating pharmacological treatment.

“Although care and intervention before pregnancy would be ideal, greater barriers exist among pregnant women and warrant attention,” the researchers wrote. “Integrated health care delivery models between primary health care and behavioral health, mental health screening during pregnancy, and telepsychiatry services are important tools to pursue in tackling major depressive episodes among women.”

For more information, see the Psychiatric News article “APA Releases New Statement on Perinatal Disorders.”


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