Obstetrician-gynecologists’ attitudes towards premenstrual dysphoric disorder and major depressive disorder

Abstract

Nine hundred ninety-seven fellows of the American College of Obstetricians and Gynecologists were surveyed by mailed questionnaire regarding their attitudes toward the conceptualization, diagnosis and treatment of premenstrual dysphoric disorder (PMDD) and major depressive disorder (MDD). Hypothesized differences in attitudes based on age, gender and professional identity as a primary care provider versus non-primary care provider were examined. Comparisons between attitudes toward PMDD and MDD were also investigated. Approximately 36% of the questionnaires were completed and returned. Overall attitudes toward PMDD versus MDD were found to be significantly different. Roughly one in three respondents disagreed with statements indicating responsibility for and confidence in their ability to treat MDD, but not PMDD. When significant differences were found for age, gender and professional identity, younger physicians, women physicians and those who self-identified as primary care providers reported attitudes that may be more likely to be associated with diagnosis and treatment of MDD and PMDD in gynecologic practice. For example, about 41% of self-identified non-primary care providers and 14.8% of primary care providers disagreed with the statement 'treating depression is my responsibility as a gynecologist'. Differences in gynecologists' attitudes toward MDD versus PMDD may be associated with under-treatment of MDD in gynecologic practice.

Obstetrician-gynecologists' decision making about the diagnosis of major depressive disorder and premenstrual dysphoric disorder

“…This generated an overall response rate of 335 of 917 (36%) for the total sample. Further details on respondents and non-respondents are discussed elsewhere [33]. Response rates for MDD vs. PMDD versions of the questionnaire were not significantly different (N = 174 for MDD and N = 161 for PMDD, w2 = 0.621 (1), p = 0.44).…”

“…The Collaborative Ambulatory Research Network is a nationwide sample of obstetrician-gynecologists who voluntarily participate in ACOG Research Department postal questionnaire studies. A detailed description of participant selection procedures is reported elsewhere [33]. No participant specifications were made regarding selection by age or sex.…”

Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder

“…Currently, mental health providers who are trained to manage suicide risk (e.g., psychiatrists, psychologists) are not systematically trained in detection and treatment of PMDD [ 29 – 31 ], despite evidence that it is a behavioral disorder with a neurobiological etiology [ 15 ]. While some training guidelines in gynecology [ 32 ] do include requirements to learn basic detection and treatment for the condition, they generally do not receive training in full evidence-based care for PMDD [ 33 ], and are not systematically trained in managing patients experiencing STBs [ 34 ]. As a result, patients seeking treatment for PMDD may have to choose between a provider who is somewhat knowledgeable about PMDD (gynecology) and a provider who can help them to manage their STBs (psychiatry, psychology).…”

Prevalence of Lifetime Self-Injurious Thoughts and Behaviors in a Global Sample of 599 Patients Reporting Prospectively Confirmed Diagnosis with Premenstrual Dysphoric Disorder

“…Currently, mental health providers who are trained to manage suicide risk (e.g., psychiatrists, psychologists) are not systematically trained in detection and treatment of PMDD [29][30][31]despite evidence that it is a behavioral disorder with a neurobiological etiology [15]. While some training guidelines in gynecology [32] do include requirements to learn basic detection and treatment for the condition, they generally do not receive training in full evidence-based care for PMDD [33], and are not systematically trained in managing patients experiencing STBs [34]. As a result, patients seeking treatment for PMDD may have to choose between a provider who is somewhat knowledgeable about PMDD (gynecology) and a provider who can help them to manage their STBs (psychiatry, psychology).…”