title: The association between maternal depression and frequent non-routine visits to the infant's doctor--a cohort study.
abstract: BACKGROUND
  Perinatal depression is common, but women typically do not seek help for it. We studied its association with frequent non-routine physician visits, which may be a form of help-seeking behaviour.
  
  
  METHODS
  A prospective cohort study of women in their 34th to 38th week of pregnancy at the outpatient obstetrics clinic at a Singapore tertiary hospital was done. Screening was done using the Edinburgh Postnatal Depression Scale and diagnosis of major or minor depressive disorder was made using the SCID-IV. At 6 to 12 months' post-partum, women were screened and interviewed again for depression and asked to report the frequencies with which they had brought their infants to the doctor on non-routine visits in the preceding 6 weeks. Four hundred and seventy-one of the 559 patients recruited before delivery were re-interviewed.
  
  
  RESULTS
  After adjusting for confounders, women who had brought their infants for three or more non-routine visits to the infant's doctor had a significantly higher prevalence of depression (32.6%) than those with fewer visits (13.6%) (OR 2.87, 95% CI 1.41 to 5.85, p=0.004). The relative risk reduction for women who did not bring their infants for frequent non-routine visits was 0.583 (95% CI 0.44 to 0.73, p=0.002). They were also more likely to have poorer perceived emotional support from their families.
  
  
  CONCLUSIONS
  These included use of self-reported doctor visits, and relatively high educational levels of the participants.
  
  
  CONCLUSIONS
  Doctors should have a high index of suspicion for enquiring about depression and emotional support in mothers who bring their infants for frequent non-routine visits.
authors.affiliation: Department of Psychological Medicine, National University Hospital, Lower Kent Ridge Road, Singapore 119074, Singapore. pcmcheec@nus.edu.sg
authors.forename: Cornelia Y I
authors.initials: CY
authors.lastname: Chee
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.forename: T P
authors.initials: TP
authors.lastname: Ng
authors.forename: Dominic T S
authors.initials: DT
authors.lastname: Lee
authors.forename: L K
authors.initials: LK
authors.lastname: Tan
authors.forename: Calvin S L
authors.initials: CS
authors.lastname: Fones
mesh_terms: D000328:Adult; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007224:Infant Care / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D010372:Pediatrics / Q000706:statistics & numerical data; D011247:Pregnancy; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data