Obstetrician-gynecologists' screening patterns for anxiety during pregnancy

Abstract

As obstetrician-gynecologists (ob-gyns) take on a greater role in women's healthcare, it is important that they are aware of the high prevalence of anxiety disorders in their patient population. Anxiety disorders present during pregnancy can have detrimental effects on both mother and child. In this study, we queried 1,193 ob-gyns on their screening rates, practice patterns, training, and knowledge as they relate to anxiety disorders during pregnancy. We achieved a 44% response rate (n=397) after three mailings. Physicians reported a moderate interest in screening for and diagnosing anxiety, but less interest in treatment. Only 20% of respondents (n=79) screen for anxiety during pregnancy, and they typically refer anxiety-disordered patients to mental health professionals. Ob-gyns with comprehensive or adequate training were significantly more likely to screen than those who stated that their training was inadequate. Having a friend who has been diagnosed with an anxiety disorder also significantly increased both the likelihood that these physicians would screen and the reported level of interest in screening of anxiety disorders during pregnancy. At present, the majority of ob-gyns feel that their training in this area was barely adequate to inadequate. Specifically, generalized anxiety disorder may be the least understood. Increased training in this area would allow ob-gyns to overcome what they list as the primary barrier to anxiety screening during pregnancy--that is, inadequate training about anxiety disorders.

United States obstetrician-gynecologists' accuracy in the simulation of diagnosing anxiety disorders and depression during pregnancy

“…Demographic data are reported elsewhere [12]. In summary, 51% of respondents were female and 49% were male, they had been in practice an average of 14.4 years (SD ¼ 9.3), and they considered themselves either specialist (44%) or both primary care physician and specialist (55%).…”

“…This questionnaire was utilized in another study assessing anxiety screening patterns during pregnancy [12]. There were three mailings of the survey, beginning in November 2005.…”

“…Unfortunately, detection rates of depression and anxiety in obstetric-gynecologic settings are low [2,[9][10][11]. As few ob-gyns report screening for anxiety (20%) [12] and depression (44%) [13], it is not surprising that these mental health issues are not detected as often as would be ideal. Ob-gyns report having had little training in managing the psychosocial issues that women encounter [4,14], and this gap in knowledge likely affects diagnostic accuracy.…”

Routine physical activity and healthy pregnant women's self reports of psychological distress: a literature review

“…Despite growing awareness, it is noted that health care providers' detection of psychological distress during pregnancy remains low (Bennett et al, 2004a;Coleman, Carter, Morgan, & Schulkin, 2008). Additionally, the effectiveness of commonly prescribed treatment regimes, such as pharmacotherapy or psychotherapy, is frequently reported as being sub-optimal (Marcus & Flynn, 2007).…”

“…Another reason why feelings of anxiety or depressed mood may go unrecognized is a lack of screening by care providers. A study by Coleman et al (2008) found that only 20% of physician respondents screen for anxiety during pregnancy.…”