Detection, Treatment, and Referral of Perinatal Depression and Anxiety by Obstetrical Providers
Detection, Treatment, and Referral of Perinatal Depression and Anxiety by Obstetrical Providers
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DOI：
10.1089/jwh.2008.1352
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发表时间：
2010-03-01
影响因子：
3.5
通讯作者：
Tyer-Viola, Lynda
中科院分区：
文献类型：
--
作者：
Goodman, Janice H.;Tyer-Viola, Lynda
目的：本研究的目的是评估产科医生在怀孕期间和产后6周对产妇抑郁和焦虑的检测、治疗和转诊率。在一家大型城市教学医院接受产科护理的妇女的便利样本（n=491）在怀孕的第三个三个月和产后6周再次使用爱丁堡产后抑郁症筛查抑郁和焦虑量表和患者健康问卷的焦虑部分。参与者还被问及他们是否认为他们在两个时间点需要抑郁，焦虑或压力的帮助。产科医生对筛查结果不知情。分娩后两个月，每个妇女的产科电子病历（EMR）进行了审查的文件精神症状，诊断，精神病治疗和精神健康转介在两个时间点。数据进行了分析，使用描述性statistics.Results：23%的参与者筛选阳性的焦虑症或高水平的抑郁症状或产前，17%的筛选阳性产后6周。大多数筛查呈阳性的妇女在怀孕或产后没有被其提供者发现。只有15%的积极筛查参与者在怀孕期间的EMR中有任何心理健康治疗的证据，转介到心理健康或社会服务的比率同样低。在产后期间，只有25%的阳性筛查产后妇女接受了治疗，另有2.5%的人被转诊。低比例的妇女谁报告说，他们觉得需要帮助的抑郁症，焦虑，或压力产前或产后接受治疗或referreration.Conclusions：这些研究结果表明，产科提供者的围产期抑郁症的检测，治疗和转诊严重缺乏，需要加以解决。
Aims: This study aimed to assess the rates of detection, treatment, and referral of maternal depression and anxiety by obstetrical providers during pregnancy and at 6 weeks postpartum.Methods: A convenience sample of women receiving obstetrical care at a large urban teaching hospital (n=491) was screened for depression and anxiety during the third trimester of pregnancy and again at 6 weeks postpartum using the Edinburgh Postnatal Depression Scale and the anxiety portions of the Patient Health Questionnaire. Participants were also asked if they thought they needed help for depression, anxiety, or stress at the two time points. Obstetrical providers were blind to screening results. Two months postdelivery, each woman's obstetrical electronic medical record (EMR) was reviewed for documentation of psychiatric symptoms, diagnoses, psychiatric treatment, and mental health referrals at the two time points. Data were analyzed using descriptive statistics.Results: Twenty-three percent of participants screened positive for an anxiety disorder or high levels of depressive symptoms or both prenatally, and 17% screened positive at 6 weeks postpartum. The majority of women who screened positive were not identified by their providers during pregnancy or postpartum. Only 15% of positively screened participants had evidence of any mental health treatment in their EMR during pregnancy, with equally low rates of referral to mental health or social services. In the postpartum period, only 25% of positively screened postpartum women received treatment, and an additional 2.5% were referred. A low proportion of women who reported they felt a need for help with depression, anxiety, or stress prenatally or postpartum received treatment or referral.Conclusions: These findings indicate that detection, treatment, and referral of perinatal depression by obstetrical providers are seriously lacking and need to be addressed.