Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age, 2005-2009.
BACKGROUND
Depression is often undiagnosed and untreated. It is not clear if differences exist in the diagnosis and treatment of depression among pregnant and nonpregnant women. We sought to estimate the prevalence of undiagnosed depression, treatment by modality, and treatment barriers by pregnancy status among U.S. reproductive-aged women.


METHODS
We identified 375 pregnant and 8,657 nonpregnant women 18-44 years of age who met criteria for past-year major depressive episode (MDE) from 2005-2009 nationally representative data. Chi-square statistics and adjusted prevalence ratios (aPR) were calculated.


RESULTS
MDE in pregnant women (65.9%) went undiagnosed more often than in nonpregnant women (58.6%) (aPR 1.1, 95% confidence interval [CI] 1.0-1.3). Half of depressed pregnant (49.6%) and nonpregnant (53.7%) women received treatment (aPR 1.0, 95% CI 0.90-1.1), with prescription medication the most common form for both pregnant (39.6%) and nonpregnant (47.4%) women. Treatment barriers did not differ by pregnancy status and were cost (54.8%), opposition to treatment (41.7%), and stigma (26.3%).


CONCLUSIONS
Pregnant women with MDE were no more likely than nonpregnant women to be diagnosed with or treated for their depression.
Epidemic Intelligence Service, Office of Workforce and Career Development, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. jeanko@cdc.gov
Jean Y
JY
Ko
Sherry L
SL
Farr
Patricia M
PM
Dietz
Cheryl L
CL
Robbins
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003376:Counseling / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008423:Maternal Age; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000628:therapy*; D037841:Pregnant People / Q000523:psychology*; D055553:Prescription Drugs / Q000627:therapeutic use; D015995:Prevalence; D060728:Reproductive Health; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D055553:Prescription Drugs