Depression Screening During, Post-Pregnancy Urged

Source: Depression Screening During, Post-Pregnancy Urged

All U.S. adults, including pregnant and postpartum women, should be screened for depression by their family doctor, the nation’s leading preventive medicine panel recommends.

Further, doctors need to follow through and get treatment for anyone who tests positive for depression, the U.S. Preventive Services Task Force concluded in an update of its depression screening guidelines.

This is the first time the panel has specifically advocated depression screening in pregnancy and shortly after giving birth. It cited a U.S. study that found that 9 percent of pregnant women and more than 10 percent of postpartum women exhibited signs of major depression.

The American College of Obstetricians and Gynecologists (ACOG) applauded the recommendation.

“Because fewer than 20 percent of women in whom perinatal depression is diagnosed self-report their symptoms, routine screening by physicians is important for ensuring appropriate follow-up and treatment,” said ACOG president Dr. Mark DeFrancesco in a statement.

Depression can harm both the child and mother, interfering with their interactions and affecting social relationships and school performance, the panel noted. Risk factors during pregnancy and after delivery include poor self-esteem, child-care stress, prenatal anxiety and decreased social support, the report said.

The new report — published Jan. 26 in the Journal of the American Medical Association — updates a similar recommendation the panel issued in 2009 that called for routine screening of adults.

In general, primary care physicians should be able to treat most cases of uncomplicated depression, and refer more complex cases to a psychiatrist, said Dr. Michael Pignone, a member of the task force and director of the University of North Carolina’s Institute for Healthcare Quality Improvement.

“That’s part of our job,” Pignone said.

Options for treatment include therapy with a psychologist or licensed clinical social worker or antidepressant medications.

The task force is an independent, volunteer panel of national experts in preventive medicine. It issues recommendations, and revisits them on a regular basis to make sure that medical evidence still supports the guidelines.

Depression is among the leading causes of disability in persons 15 years and older, the panel noted.

All U.S. adults, including pregnant and postpartum women, should be screened for depression by their family doctor, the nation’s leading preventive medicine panel recommends.

Further, doctors need to follow through and get treatment for anyone who tests positive for depression, the U.S. Preventive Services Task Force concluded in an update of its depression screening guidelines.

This is the first time the panel has specifically advocated depression screening in pregnancy and shortly after giving birth. It cited a U.S. study that found that 9 percent of pregnant women and more than 10 percent of postpartum women exhibited signs of major depression.

The American College of Obstetricians and Gynecologists (ACOG) applauded the recommendation.

“Because fewer than 20 percent of women in whom perinatal depression is diagnosed self-report their symptoms, routine screening by physicians is important for ensuring appropriate follow-up and treatment,” said ACOG president Dr. Mark DeFrancesco in a statement.

Depression can harm both the child and mother, interfering with their interactions and affecting social relationships and school performance, the panel noted. Risk factors during pregnancy and after delivery include poor self-esteem, child-care stress, prenatal anxiety and decreased social support, the report said.

The new report — published Jan. 26 in the Journal of the American Medical Association — updates a similar recommendation the panel issued in 2009 that called for routine screening of adults.

In general, primary care physicians should be able to treat most cases of uncomplicated depression, and refer more complex cases to a psychiatrist, said Dr. Michael Pignone, a member of the task force and director of the University of North Carolina’s Institute for Healthcare Quality Improvement.

“That’s part of our job,” Pignone said.

Options for treatment include therapy with a psychologist or licensed clinical social worker or antidepressant medications.

The task force is an independent, volunteer panel of national experts in preventive medicine. It issues recommendations, and revisits them on a regular basis to make sure that medical evidence still supports the guidelines.

Depression is among the leading causes of disability in persons 15 years and older, the panel noted.

Doctors also should be open to other forms of treatment for depression, such as cognitive-behavioral therapy or light therapy, said Elizabeth Saenger, a psychologist in private practice in New York City.

Light therapy affects the body’s production of the hormone serotonin, and studies have shown it can help alleviate depression symptoms, Saenger said.

It makes sense for primary care doctors to lead the way on depression screening because they see patients most often, said Dr. Alan Manevitz, a psychiatrist with Lenox Hill Hospital in New York City.

Treating depression can help patients face other health problems with which they are struggling. “As depression gets worse, so many other chronic illnesses also get worse,” Manevitz said. “People don’t take care of their health as well when they are depressed.”

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