title: Presenting symptoms of women with depression in an obstetrics and gynecology setting.
abstract: OBJECTIVE
  To describe the presenting symptoms of women with depression in two obstetrics and gynecology clinics, determine depression diagnosis frequency, and examine factors associated with depression diagnosis.
  
  
  METHODS
  Data were extracted from charts of women screening positive for depression in a clinical trial testing a collaborative care depression intervention. Bivariate and multivariable analyses examined patient factors associated with the diagnosis of depression by an obstetrician-gynecologist (ob-gyn).
  
  
  RESULTS
  Eleven percent of women with depression presented with a psychologic chief complaint but another 30% mentioned psychologic distress. All others noted physical symptoms only or presented for preventive care. Ob-gyns did not identify 60% of women with a depression diagnosis. Depression severity was similar in women who were or were not diagnosed by their ob-gyns. Bivariate analyses showed four factors significantly associated with depression diagnosis: reporting a psychologic symptom as the chief complaint or associated symptom (72% compared with 18.6%, P<.001), younger age (35.5 years compared with 40.8 years, P<.005), being within 12 months postpartum (13.9% compared with 2.8%, P<.005), and a primary care-oriented visit (72% compared with 30%, P<.001). Multivariable analysis showed that reporting a psychologic symptom (adjusted odds ratio [OR] 8.90, 95% confidence interval [CI] 4.15-19.10, P<.001), a primary care oriented visit (adjusted OR 2.46, 95% CI 1.14-5.29, P=.03), and each year of increasing age (adjusted OR 0.96, 95% CI 0.93-0.96, P=.02) were significantly associated with a depression diagnosis.
  
  
  CONCLUSIONS
  The majority of women with depression presented with physical symptoms; most women with depression were not diagnosed by their ob-gyn, and depression severity was similar in those diagnosed and those not diagnosed.
  
  
  METHODS
  III.
authors: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, the Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Harborview Medical Center, and Northwest Women's Healthcare, Seattle, Washington.
authors: Joseph M
authors: JM
authors: Cerimele
authors: Erik R
authors: ER
authors: Vanderlip
authors: Carmen A
authors: CA
authors: Croicu
authors: Jennifer L
authors: JL
authors: Melville
authors: Joan
authors: J
authors: Russo
authors: Susan D
authors: SD
authors: Reed
authors: Wayne
authors: W
authors: Katon
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data*; D006801:Humans; D009774:Obstetrics / Q000706:statistics & numerical data*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D014861:Washington / Q000453:epidemiology
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