Detection, Treatment, and Referral of Perinatal Depression and Anxiety by Obstetrical Providers

Goodman, Janice H.; Tyer-Viola, Lynda

doi:10.1089/jwh.2008.1352

Cited by 192 publications

(145 citation statements)

References 75 publications

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“…Despite their high prevalence they are often overlooked by health professionals: the likelihood of women seeking help or being identified is below 50% even in well-funded health systems (Vesga-López et al, 2008;Ko et al, 2012;Howard et al, 2014). Of those who are clinically detected, only 10-15% get effective treatment (Woolhouse et al, 2009;Goodman and Tyer-Viola, 2010;Gavin et al, 2015). The impacts of perinatal mental illness on mothers and children are many; here we focus on the wide-ranging and intergenerational economic consequences.…”

Section: Introductionmentioning

confidence: 99%

Lifetime costs of perinatal anxiety and depression

Bauer

Knapp

Parsonage

2016

Journal of Affective Disorders

266

202

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BackgroundAnxiety and depression are common among women during pregnancy and the year after birth. The consequences, both for the women themselves and for their children, can be considerable and last for many years. This study focuses on the economic consequences, aiming to estimate the total costs and health-related quality of life losses over the lifetime of mothers and their children. MethodA pathway or decision modelling approach was employed, based on data from previous studies. Systematic and pragmatic literature reviews were conducted to identify evidence of impacts of perinatal anxiety and depression on mothers and their children. ResultsThe present value of total lifetime costs of perinatal depression (anxiety) was £75,728 (£34,811) per woman with condition. If prevalence estimates were applied the respective cost of perinatal anxiety and depression combined was about £8,500 per woman giving birth; for the United Kingdom, the aggregated costs were £6.6 billion. The majority of the costs related to adverse impacts on children and almost a fifth were borne by the public sector. LimitationsThe method was exploratory in nature, based on a diverse range of literature and encountered important data gaps. ConclusionsFindings suggest the need to allocate more resources to support women with perinatal mental illness. More research is required to understand the type of interventions that can reduce long-term negative effects for both mothers and offspring. Highlights Using modelling techniques, we estimated the lifetime costs of perinatal depression and anxiety reflecting the impact on mothers and children 1 ALSPAC = Avon Longitudinal Study of Parents and Children, ED = Education, HRQoL = Health-related quality of life, HSC = Health and social care, OOP = Out-of-pocket expenditure, NHS = National Health Service, p = probability, PL = Productivity loss, pp. = percentage points, PTB = Pre-term birth, RD = Risk difference, UC = Unpaid care, UK = United Kingdom, wks. = weeks, yrs. = years 2  We found that costs were substantial and that the majority related to the impact on children  There is a need to understand the role of interventions in alleviating symptoms and reducing long-term negative effects for both mothers and offspring.  New costing methods are required for conditions with transgenerational origins and impact.

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Section: Introductionmentioning

confidence: 99%

Lifetime costs of perinatal anxiety and depression

Bauer

Knapp

Parsonage

2016

Journal of Affective Disorders

266

202

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“…There is some evidence that poor levels of depression literacy during the perinatal period may hinder women's recognition of their symptoms, which may compromise their ability to identify the need for help (Goodman & Tyer-Viola, 2010). Congruently, the promotion of depression literacy has been considered a facilitator of women's recognition of their emotional state during the perinatal period (Buist et al, 2007;Dennis & Chung-Lee, 2006).…”

mentioning

confidence: 99%

Depression Literacy and Awareness of Psychopathological Symptoms During the Perinatal Period

Fonseca¹,

Silva²,

Canavarro³

2017

Journal of Obstetric, Gynecologic & Neonatal Nursing

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“…These differences represent stark racial-ethnic disparities potentially related to outreach, detection, service provision, quality, and processes of postpartum mental health care. Although suboptimal detection and treatment rates are not uncommon for this condition or in this population (7,42,43), these results emphasize that postpartum depression remains an underrecognized and undertreated condition for all low-income women, especially for those from racial and ethnic minority groups.…”

Section: Discussionmentioning

confidence: 75%

“…We excluded 841 women with a diagnosis of bipolar disorder or schizophrenia because specific treatment requirements for these illnesses differ from recommended care for depression (7,28). In addition, in order to distinguish new onset of depressive illness in the postpartum period from an ongoing episode, we excluded 1,193 women who received any antidepressant medication during pregnancy or who had any prenatal diagnosis of depression or anxiety, because anxiety is often a feature of depressive episodes and may be prone to misclassification in administrative claims data (7,29).…”

Section: Methodsmentioning

confidence: 99%

Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women

Kozhimannil¹

2011

Psychiatric Services

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Objective The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients. Methods In a retrospective cohort study, administrative claims data from New Jersey’s Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-ethnic differences were estimated with logistic regression for initiation of antidepressant medication or outpatient mental health visits within six months of delivery, follow-up (a prescription refill or second visit), and continued mental health care (at least three visits or three filled antidepressant prescriptions within 120 days). Results Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p<.001) lower for blacks (adjusted odds ratio [AOR]=.43) and Latinas (AOR=.59) compared with whites. Among those who initiated treatment, blacks and Latinas were less likely than whites to receive follow-up treatment (blacks, AOR=.66, p<.001; Latinas, AOR=.67, p<.05) or continued care (blacks, AOR=.81, marginal difference at p<.10; Latinas, AOR=.67, p<.05). Among those who initiated antidepressant treatment, black women and Latinas were less likely than whites to refill a prescription. Conclusions There were significant racial-ethnic differences in depression-related mental health care after delivery. Suboptimal treatment was prevalent among all low-income women in the study. However, racial and ethnic disparities in the initiation and continuation of postpartum depression care were particularly troubling and warrant clinical and policy attention.

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Detection, Treatment, and Referral of Perinatal Depression and Anxiety by Obstetrical Providers

Abstract: These findings indicate that detection, treatment, and referral of perinatal depression by obstetrical providers are seriously lacking and need to be addressed.

Cited by 192 publications

References 75 publications

Lifetime costs of perinatal anxiety and depression

Lifetime costs of perinatal anxiety and depression

Depression Literacy and Awareness of Psychopathological Symptoms During the Perinatal Period

Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women

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