Science News & Science Current Events
 
Email a Friend Send to a friend
Printer Friendly Print Two-thirds of pregnant women with depression aren't getting treatment for it

Two-thirds of pregnant women with depression aren't getting treatment for it

August 15, 2006

Many others with signs of depression receive inadequate care, putting moms and babies at risk

Ann Arbor, Mich. - The majority of pregnant women who have full-blown major depression aren't getting any treatment for the condition, and neither are most pregnant women who have signs of milder depression or depression risk, a new University of Michigan Depression Center study finds.




Even those who are receiving some form of treatment may not be getting enough, the researchers conclude in the current issue if General Hospital Psychiatry. Without adequate treatment - medication, talk therapy, or both together - prenatal and post-partum depression can seriously impact both women and their babies.

The findings come from a study of 1,837 pregnant women who were surveyed in the waiting rooms of five Michigan obstetrics clinics, using a standard questionnaire that detects signs of depression.

Of the women in the study, 276 met the criteria for being at risk of depression. All of these women had follow-up interviews with trained mental health workers who assessed them using the standard criteria used to diagnose depression, and asked them about their mental health and treatment history.

In all, 17 percent of the 276 women were found to be experiencing a serious depression. Another 23 percent had a history of major depression, which can come and go throughout life and needs regular monitoring and treatment. Of those who were experiencing major depression at the time of the study, only 33 percent were receiving any treatment for it. And of the 276 women with high depression risk, only 20 percent were receiving treatment, despite the fact that many had a history of depression.

When the researchers analyzed data on the at-risk and depressed women who were receiving treatment, they found that only 43 percent of those taking anti-depressant medications (alone or in combination with talk therapy) had been taking them at the recommended dose for at least six weeks. Such medications often must be taken for six to eight weeks before depression symptoms ease.

Heather Flynn, Ph.D., the U-M psychologist who led the study, calls the result very troubling. "These are women who meet the formal clinical criteria for the most severe form of depression. No one would argue that these women would benefit from some form of intervention, but only 33 percent of them were," she says. "It may be impossible to closely monitor every pregnant woman at risk in the way this study did, but it certainly makes sense to ensure that women with clear depression get the help they need."

Flynn and her colleague Sheila Marcus, M.D., have led an effort to screen pregnant women for depression in the waiting rooms of obstetric clinics at U-M and elsewhere in southern Michigan. They previously published results based on the waiting-room screening tests; the new study goes much further by performing a detailed psychological assessment using the criteria of the DSM-IV, the standard text for diagnosing mental health conditions.

Their results show no significant depression or depression-treatment differences among pregnant women of different races and ethnicities, employment situations, education levels, and marital or parental situations. The only factors that were found to increase a woman's chance of treatment were severe symptoms at the time of the study, a history of major depression and a history of any psychiatric treatment,

This suggests that women who are already accustomed to accessing the mental health system may be most likely to do so if they experience depressive symptoms during pregnancy, while other women may not recognize their symptoms - or may not know, or believe, that they can get help from a mental health provider.

Flynn, who treats patients as part of the Depression Center's clinical team, says she sees this phenomenon in her own work. "A lot of the women I see don't really appreciate that the way they've been feeling isn't normal, particularly during pregnancy," she says. "They attribute their fatigue, sleep and other problems to pregnancy, or don't believe that they could be suffering from depression. Others may suspect a problem but don't believe that treatment can work. But it can."

Another major barrier to depression treatment may be the lack of awareness among the doctors who treat women during pregnancy, but this seems to have improved in recent years, says Flynn. Many women, however, still are never screened for depression or treated to prevent a recurrence of past depression.

She and her colleagues are now preparing another paper that assesses the impact of screening pregnant women for depression, based on the results from the study group. "We're hoping to see if some of the approaches used in to help link people who have other health issues with needed treatments may help women work through the ambivalence or skepticism about treatment, help them engage in the treatment process," she says.

Depression during pregnancy: Symptoms and treatment

Pregnant women who are experiencing depression may think their symptoms are just a normal part of pregnancy. But in fact, the following signs may indicate depression: two or more weeks of depressed mood, decreased interest or pleasure in activities, change in appetite, change in sleep patterns, fatigue or loss of energy, difficulty concentrating, excessive feelings of worthlessness or guilt, thoughts of suicide, extreme restlessness and irritability.

Severe depression during pregnancy can interfere with women's ability to eat properly, get enough rest, or receive prenatal care - all of which may contribute to premature and low birth-weight infants. Even mild depression during pregnancy can put a woman at risk of more severe post-partum depression, which can interfere with her ability to care for her newborn and herself. Pregnant women who are experiencing possible signs of depression, or who have a history of depression, should talk to their doctors or midwives immediately. Medications, talk therapy, stress reduction, exercise and other steps can help ease depression safely during pregnancy and beyond.

University of Michigan Health System



Related Depression Current Events and Depression News Articles Depression Current Events and Depression News RSS Depression Current Events and Depression News RSS
Has a new era of reinstitutionalization in mental health care begun?
A retrospective analysis of hospital episode statistics, involuntary admissions under the Mental Health Act 1983, and the number of psychiatric beds in England 1996-2006.

Compassion meditation may improve physical and emotional responses to psychological stress
Data from a new study suggests that individuals who engage in compassion meditation may benefit by reductions in inflammatory and behavioral responses to stress that have been linked to depression and a number of medical illnesses.

Millisecond brain signals predict response to fast-acting antidepressant
Images of the brain's fastest signals reveal an electromagnetic marker that predicts a patient's response to a fast-acting antidepressant, researchers have discovered.

Bullying of teenagers online is common, UCLA psychologists report
Nearly three in four teenagers say they were bullied online at least once during a recent 12-month period, and only one in 10 reported such cyber-bullying to parents or other adults, according to a new study by UCLA psychologists.

Getting help for depression and anxiety has significant long-term benefits
According to the Mood Disorder Society of Canada, about 1.3 million Canadians suffer from depression.

Smoking increases depression in women, study reveals
Researchers from the University of Melbourne and Barwon Health assessed a group of 1043 Australian women, whose health had been monitored for a decade as part of the Geelong Osteoporosis Study.

Learning to shape your brain activity
A study in the Oct. 1 issue of the journal Sleep shows that the successful manipulation of sensorimotor rhythm (SMR) amplitude by instrumental SMR conditioning (ISC) improved sleep quality as well as declarative learning. ISC might thus be considered a promising non-pharmacological treatment for primary insomnia.

Adolescent insomnia linked to depression and substance abuse during adolescence and young adulthood
A study in the Oct. 1 issue of the journal Sleep shows that adolescent insomnia symptoms are associated with depression, suicide ideation and attempts, and the use of alcohol, cannabis and other drugs such as cocaine.

MS patients have higher spinal fluid levels of suspicious immune molecule
A protein that helps keep immune cells quiet is more abundant in the spinal fluid of patients with multiple sclerosis (MS), further boosting suspicion that the protein, TREM-2, may be an important contributor to the disease.

Mental health intervention urged for heart patients
Heart patients are particularly vulnerable to depression and should be screened, and if necessary treated, to improve their recovery and overall health, according to a scientific advisory issued Monday by the American Heart Association and co-authored by a Yale School of Public Health researcher.
More Depression Current Events and Depression News Articles


The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness
by J. Mark G. Williams, John D. Teasdale, Zindel V. Segal, Jon Kabat-Zinn

The Mindful Way through Depression draws on the collective wisdom of four internationally renowned cognitive therapy and mindfulness experts, including bestselling author Jon Kabat-Zinn, to help you break the mental habits that can lead to despair. This authoritative, easy-to-use self-help program is based on methods clinically proven to reduce the recurrence of chronic unhappiness. Informative...



The Forgotten Man: A New History of the Great Depression
by Amity Shlaes

In The Forgotten Man, Amity Shlaes, one of the nation's most-respected economic commentators, offers a striking reinterpretation of the Great Depression. She traces the mounting agony of the New Dealers and the moving stories of individual citizens who through their brave perseverance helped establish the steadfast character we recognize as American today....



Essays on the Great Depression
by Ben S. Bernanke

Few periods in history compare to the Great Depression. Stock market crashes, bread lines, bank runs, and wild currency speculation were worldwide phenomena--all occurring with war looming in the background. This period has provided economists with a marvelous laboratory for studying the links between economic policies and institutions and economic performance. Here, Ben Bernanke has gathered...



The Great Depression: America 1929-1941
by Robert S. Mcelvaine

A perennial backlist...



The Second Great Depression
by Warren Brussee

The Second Great Depression This is a frightening book. It shows how massive consumer debt triggered this second depression, which started in 2007/2008. The exuberance of the overheated stock market of the 90s caused consumers to stop saving and go into debt. Then, the dramatic drop in mortgage rates enabled people to refinance their homes and go even further into debt. People were no...



Undoing Depression
by Richard O'Connor

For some people, depression has been a part of their experience for so long that they've begun to believe it's what they are. They become experts at "doing" depression--hiding it, working around it, even achieving great things (but at the price of great struggle, and little satisfaction). In this book, psychotherapist Richard O'Conner shows us how to "undo" depression, by replacing depressive...



Rethinking the Great Depression (American Ways Series)
by Gene Smiley

Drawing upon recent economic scholarship to present a clear and nontechnical analysis, Mr. Smiley offers new insights and some surprising conclusions about the causes of the Great Depression, the consequences of the New Deal, and the economic effects of World War II. An accessible survey...challenges the popular belief that the Great Depression demonstrates the instability of markets and the need...



America's Great Depression
by Murray N. Rothbard

Applied Austrian economics doesn't get better than this. Murray N. Rothbard's America's Great Depression is a staple of modern economic literature and crucial for understanding a pivotal event in American and world history. The Mises Institute edition features, along with a new introduction by historian Paul Johnson, top-quality paper and bindings, in line with the standard set by The...



Spiritual Depression: Its Causes and Cure
by David Martyn Lloyd-Jones

Believing that Christian joy was one of the most potent factors in the spread of Christianity in the early centuries, Lloyd-Jones not only lays bare the causes that have robbed many Christians of spiritual vitality, but also points the way to the...



The Cognitive Behavioral Workbook for Depression: A Step-by-step Program (Workbook)
by William J. Knaus

In the 1950s, Albert Ellis pioneered a form of psychotherapy that combined ways of detecting and changing irrational thoughts with techniques for replacing negative behaviors with positive ones. This type of cognitive behavioral therapy, called rational emotive behavior therapy (REBT) by Ellis, proved especially effective at relieving problems like anger, anxiety, and depression. In this book...

© 2008 BrightSurf.com