Rates and predictors of depression treatment among pregnant women in hospital-affiliated obstetrics practices.

Objective: The purpose of this study was to provide information on rates of depression treatment among pregnant women at risk for depression and among those with clinician-diagnosed current major depressive disorder (MDD) and to examine predictors of depression treatment.

Method: Women seeking prenatal care completed a screening survey (including the Center for Epidemiological Studies-Depression Scale) in several hospital-based obstetrics clinics. Women identified as high risk for depression completed diagnostic interviews (n=276) during pregnancy, consisting of the Structured Clinical Interview for DSM-IV, measures of depression symptom severity (Beck Depression Inventory-II), health functioning (SF-36) and current and past psychiatric treatment.

Results: Among women with a current MDD diagnosis, most of whom were experiencing a recurrence, 33% were currently receiving any depression treatment. The presence of current MDD was not found to be related to use of treatment. Prior history of MDD, history of psychiatric treatment and depression severity were significant predictors of depression treatment during pregnancy.

Conclusions: Most women with current MDD were found to be either untreated or suboptimally treated, and prenatal MDD was not predictive of treatment. These findings point to the need for effective detection, targeted follow-up assessment and treatment linkage interventions to be studied in medical settings that encounter perinatal women.