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Less than half of pediatricians inquire about maternal depression

Although screening for maternal depression has increased since 2004, less than half of pediatricians make a point of asking new mothers about possible depression, creating a missed opportunity to identify those who may require treatment, according to data published in the Journal of Development and Behavioral Pediatrics.

“Maternal depression is difficult to identify and treat because women with mental health issues often do not access routine health care for themselves,” Bonnie Kerker, PhD, of the Nathan Kline Institute of Psychiatric Research, in Orangeburg, N.Y., and colleagues wrote. “However, most parents report that infants do receive well-child visits, and the American Academy of Pediatrics (AAP) recommends seven well-child visits for children during the first year of life. As a result of these health care utilization patterns and the impact of maternal depression on children, pediatricians’ offices are a promising venue for identifying and managing maternal depression.”

To study how often pediatricians ask new mothers about, and screen for, maternal depression, and to identify correlates of instances when care providers do ask or screen, the researchers collected data from 788 general practice pediatricians who completed the AAP Periodic Surveys in 2004 and 2013. In the survey, pediatricians answered questions regarding physician and practice characteristics, training, attitudes and inquiries and screenings used to identify maternal depression.

The researchers used sample weights to reduce nonresponse bias, and they conducted weighted descriptive and logistic regression analysis.

According to the researchers, the prevalence of pediatricians “usually” making inquiries into, and screening for, maternal depression increased from 33% in 2004 to 44% in 2013 (P < .01). In 2004, the prevalence of usually making inquiries into, and screening for, maternal depression was greater among physicians with a predominantly white patient population, and those who received training in adult mental health. In 2013, believing that family screening is within the scope of the pediatrician’s duties was positively associated with inquiring and screening.

“This national survey of pediatric providers suggests that although inquiry about and screening for maternal depression in pediatric practices has increased, incorporating questions about maternal depression into pediatric practices is still rare: Fewer than half of providers did so in 2013,” Kerker and colleagues wrote. “… Without a concerted effort to identify maternal depression, pediatric primary care will continue to be a missed opportunity to intervene early and to improve children’s wellbeing.” – by Jason Laday