Management of Major Depression in pregnancy: A comparison of approaches by Psychiatrists and Obstetricians and Gynecologists

Abstract

Topic: Management of Major Depression in Pregnancy: A Comparison of Approaches by academic Psychiatrists and Obstetricians and Gynecologists. Purpose: Major Depression (MD) can complicate pregnancy outcome. To manage MD during pregnancy, the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA) have offered consensual recommendations. This study compares the approaches of academic physicians of these two specialties to manage MD during pregnancy. Methods: A 10 minute survey that assessed individual and self-report practices about managing MD during pregnancy was developed and sent to major academic training programs across the US. Areas assessed include modalities of intervention during mild, moderate, and severe depression, preference for counseling, preference for antidepressant intervention, comparison of use of screening tools between the two specialties, choice of antidepressant and assessment of use of non-pharmacological interventions such as ECT, light therapy and use of alternative medicines such as the Omega three fatty acids. A total of 51 Obstetrics and gynecology training program directors and a total of 18 psychiatry training program directors responded by completing and mailing back the questionnaires. Conclusions: We found that the academic Obstetricians and Gynecologists and the academic Psychiatrists differed in their approach to manage MD during pregnancy under similar circumstances. The two different approaches under similar conditions reflected the level of comfort in their respective practices.