Treatment-Seeking for Depression Among Pregnant Women

严重抑郁症每年影响超过600，000名孕妇，并且一直与母亲和发育中的婴儿的许多不良后果有关，包括自然流产，先兆子痫，手术分娩和产后抑郁症的发生率较高。虽然已经开发出有希望的干预措施来治疗这种疾病，但寻求治疗的比率仍然低得惊人，特别是在低收入和少数种族/族裔背景的孕妇中。迫切需要找到增加抑郁症孕妇，特别是来自贫困和少数民族背景的孕妇寻求适当治疗的方法。在制定干预措施或实施系统变革以提高治疗寻求率之前，我们必须首先了解治疗利用存在的障碍。由于在这一领域缺乏任何已发表的研究，研究人员目前对这些障碍知之甚少，或者这些障碍如何对来自服务不足群体的孕妇产生不同的影响。我们提出了一个探索性的混合方法的研究，这将是第一个经验性的调查障碍，抑郁症治疗在怀孕期间，特别注重确定最相关的问题，某些服务不足的患者群体。具体而言，这项调查将针对低收入抑郁症的拉丁裔和非拉丁裔白色患者在产科诊所服务经济困难的妇女。我们将结合定量和定性的方法来探讨妇女对抑郁症寻求治疗的态度，并澄清症状的识别和治疗决策的过程。我们的研究将解决三个主要目标：（1）确定具体的因素和障碍，导致低收入，抑郁的孕妇寻求抑郁症治疗，或不寻求治疗;（2）评估产前抑郁症的具体治疗的可接受性;（3）开发一个过程的初步模型，抑郁的孕妇解释症状，并选择是否寻求治疗。在一个更具探索性的基础上，我们将研究是否有差异之间观察到拉丁裔和非拉丁裔白色妇女方面的每一个主要目标。怀孕期间的抑郁症与母亲及其发育中的婴儿的许多不良后果有关;然而，大多数抑郁症孕妇没有接受任何治疗。这项研究将探讨为什么有些孕妇寻求帮助，他们的抑郁症，而其他人不。结果将有助于为这一弱势妇女群体提供更好、更容易接受和更容易获得的服务奠定基础。

DESCRIPTION (provided by applicant): Major depression affects over 600,000 pregnant women annually and has been consistently linked with numerous adverse consequences for mothers and developing infants, including higher rates of spontaneous abortion, preeclampsia, operative delivery, and postpartum depression. Although promising interventions have been developed to treat the disorder, treatment-seeking rates remain alarmingly low, particularly among pregnant women from low-income and racial/ethnic minority backgrounds. A critical need exists to find ways to increase appropriate treatment-seeking in depressed pregnant women, particularly those from poor and minority backgrounds. Prior to developing interventions or implementing system changes that attempt to increase treatment seeking rates, we must first understand the barriers that exist to treatment utilization. Given the lack of any published research in this area, researchers currently know little about these barriers, or how these barriers may differentially affect pregnant women from underserved groups. We propose an exploratory mixed methods study that will be the first empirical investigation of barriers to depression treatment during pregnancy, with a particular focus on identifying issues of most relevance to certain underserved patient groups. Specifically, this investigation will target low-income depressed Latina and non-Latina White patients at an obstetrical clinic serving financially disadvantaged women. We will integrate quantitative and qualitative methods to explore women's attitudes regarding depression treatment-seeking, and to clarify processes by which symptoms are recognized and treatment decisions are made. Our research will address three primary aims: (1) To identify specific factors and barriers that lead low-income, depressed pregnant women to pursue depression treatment, or to not pursue treatment; (2) To evaluate the acceptability of specific treatments for antenatal depression; (3) To develop a preliminary model of the processes by which depressed pregnant women interpret symptoms and choose whether or not to seek treatment. On a more exploratory basis, we will examine whether or not differences are observed between Latina and non-Latina White women with regard to each of the primary aims. Depression during pregnancy is associated with numerous adverse consequences for mothers and their developing infants; however, the majority of depressed pregnant women do not receive any treatment. This study will examine the reasons why some pregnant women seek help for their depression, and others do not. Results will help provide the basis for better, more acceptable, and accessible services for this vulnerable group of women.