Collaborative Care for Perinatal Depression Among Socioeconomically Disadvantaged Women: Adverse Neonatal Birth Events and Treatment Response.

Objective: The study examined the effectiveness of a perinatal collaborative care intervention in moderating the effects of adverse neonatal birth events on risks of postpartum depressive symptoms and impaired functioning among women of lower socioeconomic status with antenatal depression.

Methods: A randomized controlled trial with blinded outcome assessments was conducted in ten public health centers, comparing MOMCare (choice of brief interpersonal psychotherapy, pharmacotherapy, or both) with intensive maternity support services (MSS-Plus). Participants had probable diagnoses of major depressive disorder or dysthymia during pregnancy.

A randomized trial of collaborative depression care in obstetrics and gynecology clinics: socioeconomic disadvantage and treatment response.

Objective: The authors evaluated whether an obstetrics-gynecology clinic-based collaborative depression care intervention is differentially effective compared with usual care for socially disadvantaged women with either no health insurance or with public coverage compared with those with commercial insurance.

Method: The study was a two-site randomized controlled trial with an 18-month follow-up. Women were recruited who screened positive (a score of at least 10 on the Patient Health Questionnaire-9) and met criteria for major depression or dysthymia.

Improving care for depression in obstetrics and gynecology: a randomized controlled trial.

Objective: To evaluate an evidence-based collaborative depression care intervention adapted to obstetrics and gynecology clinics compared with usual care.

Methods: A two-site, randomized controlled trial included screen-positive women (Patient Health Questionnaire-9 score of at least 10) who met criteria for major depression, dysthymia, or both (Mini-International Neuropsychiatric Interview). Women were randomized to 12 months of collaborative depression management or usual care; 6-month, 12-month, and 18-month outcomes were compared.

Presenting symptoms of women with depression in an obstetrics and gynecology setting.

Objective: To describe the presenting symptoms of women with depression in two obstetrics and gynecology clinics, determine depression diagnosis frequency, and examine factors associated with depression diagnosis.

Methods: Data were extracted from charts of women screening positive for depression in a clinical trial testing a collaborative care depression intervention. Bivariate and multivariable analyses examined patient factors associated with the diagnosis of depression by an obstetrician-gynecologist (ob-gyn).

Improving depression treatment for women: integrating a collaborative care depression intervention into OB-GYN care.

Background: Women have higher rates of depression and often experience depression symptoms during critical reproductive periods, including adolescence, pregnancy, postpartum, and menopause. Collaborative care intervention models for mood disorders in patients receiving care in an OB-GYN clinic setting have not been evaluated. Study design and methodology for a randomized controlled trial of collaborative care depression management versus usual care in OB-GYN clinics and the details of the adapted collaborative care intervention and model implementation are described in this paper.

Depression in pregnancy is associated with preexisting but not pregnancy-induced hypertension.

Background: The aim was to examine whether depression is associated with preexisting hypertension or pregnancy-induced hypertension in a large sample of women attending a university-based obstetrics clinic.

Methods: In this prospective study, participants were 2398 women receiving ongoing prenatal care at a university-based obstetrics clinic from January 2004 through January 2009. Prevalence of depression was measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria based on the Patient Health Questionnaire-9 as well as the self-reported use of antidepressant medication.

Diabetes and depression in pregnancy: is there an association?

Background: Prior studies have reported inconsistent findings regarding the association of antenatal depression with pregnancy-related diabetes. This study examined the association of diabetes and antenatal depression.

Methods: We conducted a cross-sectional analysis of baseline data from a prospective cohort study of pregnant women receiving prenatal care at a single University of Washington Medical Center clinic between January 2004 and January 2009.

Racial differences in the prevalence of antenatal depression.

Objective: This study examined whether there were racial/ethnic differences in the prevalence of antenatal depression based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria in a community-based sample of pregnant women.

Method: Data were drawn from an ongoing registry of pregnant women receiving prenatal care at a university obstetric clinic from January 2004 through March 2010 (N =1997). Logistic regression models adjusting for sociodemographic, psychiatric, behavioral and clinical characteristics were used to examine racial/ethnic differences in antenatal depression as measured by the Patient Health Questionnaire.

A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction.

Context: Maternal depressive symptoms during pregnancy have been reported in some, but not all, studies to be associated with an increased risk of preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR).

Objective: To estimate the risk of PTB, LBW, and IUGR associated with antenatal depression.

Data Sources And Study Selection: We searched for English-language and non-English-language articles via the MEDLINE, PsycINFO, CINAHL, Social Work Abstracts, Social Services Abstracts, and Dissertation Abstracts International databases (January 1980 through December 2009).

Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization.

Objective: We sought to estimate the frequency of self-reported fecal incontinence (FI), identify what proportion of these patients have a diagnosis of FI in their medical record, and compare health care costs and utilization in patients with different severities of FI to those without FI.

Study Design: Patients in a health maintenance organization were eligible and 1707 completed a survey. Patients with self-reported FI were assessed for a diagnosis of FI in their medical record for the last 5 years.

Psychosocial stress during pregnancy.

Objective: We sought to identify factors associated with high antenatal psychosocial stress and describe the course of psychosocial stress during pregnancy.

Study Design: We performed a cross-sectional analysis of data from an ongoing registry. Study participants were 1522 women receiving prenatal care at a university obstetric clinic from January 2004 through March 2008.

Major depression and urinary incontinence in women: temporal associations in an epidemiologic sample.

Objective: To determine whether: (1) major depression is associated with increased risk for onset of urinary incontinence, and (2) urinary incontinence is associated with increased risk for onset of depression.

Study Design: Longitudinal cohort study of female Health and Retirement Study participants completing baseline interviews at Wave 3 (1996-1997) and follow-up interviews at Waves 4-6 (1998-2003).

Results: In a cohort of 5820 women with a mean age 59.

Women's perceptions about the etiology of urinary incontinence.

Objective: Incontinent women have low rates of care seeking and treatment, some of which may be explained by their beliefs about the causes of their own urine loss. As little is known about these beliefs, our aim was to qualitatively assess what women perceive as the etiology of their urinary incontinence (UI).

Methods: In a written survey on urinary symptoms administered to female HMO enrollees aged 30-90 years, incontinent women were asked the open-ended question: "Why do you think you lose urine?" Qualitative analyses of the responses identified themes, which were quantified and organized into major categories.

Depressive symptoms, bone loss, and fractures in postmenopausal women.

Background: Osteoporosis and depression may be associated through common physiologic systems or risk factors.

Objective: To assess the associations between depressive symptoms (Burnam's scale) or antidepressant use and bone outcomes.

Design: Prospective cohort study.

Can mentors prevent and reduce burnout in new chairs of departments of obstetrics and gynecology: results from a prospective, randomized pilot study.

Objective: This study assessed burnout in new chairs of obstetrics and gynecology and whether mentoring by experienced chairs would prevent or reduce burnout.

Study Design: We performed a year-long prospective, randomized trial. Questionnaires were sent to new chairs to obtain demographic information and to identify need for mentoring and level of burnout.

Implementing a clinical and research registry in obstetrics: overcoming the barriers.

Objective: This study aimed to describe the obstacles and solutions in developing and implementing a prospective obstetric database registry that collects biopsychosocial data on women during pregnancy and postpartum. The clinical goals of the registry were to improve both diagnosis of mental health and substance use problems and access to mental health care during pregnancy. The research goals were to examine the impact of psychiatric illness and substance use on birth outcomes.

Prevalence of vitamin D insufficiency and clinical associations among veiled East African women in Washington State.

Aims: Cultural and biological factors place immigrant women from equatorial Africa at increased risk of vitamin D insufficiency. This could in part explain the high prevalence of fatigue, musculoskeletal complaints, and depressive symptoms in this population.

Methods: In a cross-sectional study of East African immigrant women in Washington State, 25-hydroxyvitamin D (25(OH)D) serum concentrations and multiple measures of physical and psychological symptoms were assessed.

Health care discussions and treatment for urinary incontinence in U.S. women.

Objective: The objective of the study was to determine the proportions of women with urinary incontinence who had discussed their condition with a health care provider or received treatment and to identify factors associated with seeking health care.

Study Design: The study was a population-based, age-stratified postal survey of 6000 women aged 30 to 90 years enrolled in a large health maintenance organization in Washington state.

Results: The response rate was 64% (n = 3536) after applying exclusion criteria.

Fecal incontinence in US women: a population-based study.

Objective: The purpose of this study was to determine the prevalence of fecal incontinence (FI) and associated risk factors in a broad age range of community-dwelling women.

Study Design: This was a population-based, age-stratified postal survey of 6000 women aged 30 to 90 years enrolled in a large HMO in Washington State. Sample was linked to longitudinal automated medical data.

Incontinence severity and major depression in incontinent women.

Objective: Research has shown an association between urinary incontinence and depression. Studies that use community-based samples and major depressive disorder diagnostic criteria are needed. The objective of this study was to estimate the prevalence of and factors associated with major depression in women with urinary incontinence.

Urinary incontinence in US women: a population-based study.

Background: Urinary incontinence (UI) is a common disorder that is increasingly important as our population ages. Less is known about UI in younger women, and few large surveys have been able to determine risk factors by linking their data to patients' medical findings.

Methods: We conducted a population-based, age-stratified postal survey of 6000 women aged between 30 and 90 years who were enrolled in a large health maintenance organization in Washington State.

Relationship between patient report and physician assessment of urinary incontinence severity.

Objective: The purpose of this study was to determine the relationship between patient report and physician assessment of urinary incontinence severity and to compare these assessments to a validated severity instrument.

Study Design: A sequential sample of 153 women with urinary incontinence was enrolled over 12 months. Patients completed a detailed health questionnaire that included a medical comorbidity scale, 12-item short-form health survey (SF-12) the incontinence quality of life instrument, the PRIME-MD patient health questionnaire, and a patient incontinence severity assessment.

Depression screening attitudes and practices among obstetrician-gynecologists.

Objective: To assess obstetrician-gynecologists' attitudes and practices related to depression screening.

Method: A total of 282 obstetrician-gynecologists completed a 36-question mail survey that assessed attitudes regarding depression screening, training to treat depression, psychosocial concern, professional influence, and ease of screening.

Result: Depression screening (employed regardless of signs or symptoms) was reported by 44% of physicians.