Obstetrician-gynecologists' knowledge, attitudes and practices regarding major depressive disorder

• Published in: Journal of psychosomatic obstetrics and gynaecology Vol. 34; no. 1; pp. 34 - 38
• Main Authors: Fuller, Elizabeth, Anderson, Britta, Leddy, Meaghan, Schulkin, Jay
• Format: Journal Article
• Language: English
• Published: New York, NY Informa UK, Ltd 01.03.2013; Taylor & Francis; Informa Healthcare
• Subjects: Adolescent; Attitude of Health Personnel; Biological and medical sciences; Depression - diagnosis; depressive disorder; Depressive Disorder, Major - diagnosis; diagnosis; Diagnostic and Statistical Manual of Mental Disorders; DSM-IV; DSM-IV-PC; Female; gynecologist; Gynecology; Health Knowledge, Attitudes, Practice; Health participants; Health staff related problems. Vocational training; Humans; Medical sciences; Mental Health; obstetrician; Obstetrics; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Social psychiatry. Ethnopsychiatry; Human; Mood disorder; DSM-IV-PC; DSM-IV; Health staff; Attitude; Gynecology; Mental health; Physician; Depression; diagnosis; Knowledge; Obstetrics; Symptomatology; Treatment; obstetrician; Adolescent; depressive disorder; gynecologist; Diagnostic and Statistical Manual IV; Public health
• ISSN: 0167-482X; 1743-8942
• DOI: 10.3109/0167482X.2012.752811

Abstract Background: Obstetrician-gynecologists (ob-gyns) provide depression screening and treatment, but these practices could be improved. This study investigated the use of depression screening tools and treatment of adolescents with depressive symptoms. Methods: Surveys were sent to 220 members of the American College of Obstetricians and Gynecologists (ACOG) who had responded to a survey on depression in the past two years. Response rate was 66% (n = 145). Questions included those related to standardized depression screening, antidepressant prescribing behavior, use of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) and knowledge of adolescent depression. Results: A total of 40% use standardized screening tools for depression with 46% using the Beck Depression Inventory-II and only 5% using the Patient Health Questionnaire-2 (PHQ-2). The majority (89%) of ob-gyns do not employ the DSM-IV to confirm a diagnosis of major depressive disorder. Of the ob-gyns indicating treating depression with antidepressants, 97% prescribe selective serotonin reuptake inhibitors. Only 19 respondents do not prescribe antidepressants, and instead refer depressed patients to mental health specialists. Most (79%) ob-gyns identified sexual problems as the primary side effect deterring prescribing of antidepressant medication. Ob-gyns were fairly accurate at estimating the prevalence of adolescent depression. Conclusion: Ob-gyns are not utilizing the recommended validated resources such as the DSM-IV or PHQ-2 for diagnosis of depression or prior to prescribing antidepressants.