Depression often not treated in pregnant women

By Charnicia Huggins

NEW YORK (Reuters Health) - Many pregnant women with depression are not receiving adequate treatment, if any, for their mental health condition, new study findings show.

"This study and others suggest that most women with debilitating, depressive illness at a vulnerable developmental period are unlikely to be connected with adequate psychiatric treatment," write Dr. Heather A. Flynn and her colleagues.

Previous studies have shown that up to 15 percent of women experience depression during pregnancy, which in turn greatly increases the risk of postpartum depression. Yet, several researchers have shown that depression goes undetected in 75 percent or more of cases.

In a further exploration of the topic, Flynn, at the University of Michigan Medical School, and her colleagues in Ann Arbor studied 276 pregnant women who had a high risk of depression, based on their symptoms and depression history.

They found that although 40 percent of the women had current depression or a history of major depression, only one in five (20 percent) was receiving any type of depression treatment

Also, less than half (43 percent) of those receiving treatment were being adequately treated with antidepressants, the investigators report in the journal General Hospital Psychiatry.

Among women with a diagnosis of major depressive disorder, most were experiencing a recurrence, Flynn and her colleagues note. This finding implies that "their symptoms and their treatment are not being monitored adequately," Flynn told Reuters Health.

Women most likely to receive treatment were those with a history of psychiatric treatment, those with a history of major depression, and those with more severe prenatal depression, study findings indicate. A current diagnosis of major depression was not associated with any use of depression treatment, however.

In light of the findings, "women need to be more proactive about making sure they get effective treatment," Flynn said.

The "good news, (is that) there are effective treatments," she added, "but the first treatment isn't always the best." With that in mind, women who are not completely satisfied with their treatment should inform their health care provider that the medication is not working, she said.

"We want women to be more aware that if they feel like something's wrong in terms of their mood... they really should talk to somebody," Flynn stressed.

SOURCE: General Hospital Psychiatry, July-August 2006.