Quest for timely detection and treatment of women with depression.
BACKGROUND
Women are at risk for a wide range of depressive and anxiety disorders and particularly for mood disorders associated with their menstrual cycle, with seasonality, and during the menopausal transition.


OBJECTIVE
To review the presentation of depression, the importance of timely and effective treatment, and some of the research surrounding increased prevalence of depression in women, and the times and conditions--such as the perimenopausal transition, pregnancy, postpartum period, and comorbidities--of this increased risk in women.


CONCLUSIONS
Dynamic interactions of both biological and environmental factors contribute to the development of major depression. These include, but are not limited to, predisposing genetic influences, gender, environmental stressors, poor social support, childhood sexual abuse, other psychiatric illness, and trauma. Timely and effective treatment of each episode of depression to remission is critically important. Barriers to instituting collaborative care of depressive illness are numerous. The lack of adequate collaborative care along with the consequent failure to adequately diagnose and treat depression reflects some of the deficiencies in the current organization and delivery of health services.


CONCLUSIONS
The prevalence of depression, its psychosocial and medical consequences, and the worsening course of depression without treatment highlight the public health importance of early detection and improved strategies for the treatment of depression in modern health care settings.
Psychiatry Women's Health Program, Kaiser Permanente, Northern California, Oakland, USA. Jeanne@afwh.org
Jeanne Leventhal
JL
Alexander
D000928:Antidepressive Agents / Q000627:therapeutic use; D001942:Breast Feeding; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008593:Menopause / Q000523:psychology; D008598:Menstruation / Q000523:psychology; D012307:Risk Factors; D012621:Seasons; D014930:Women
D000928:Antidepressive Agents