A significant number of women in the general population may have undiagnosed and untreated depressive disorders and anxiety, a new study reports. Among an unselected group of gynecologic patients, Swedish researchers, reporting in the January issue of the American Journal of Obstetrics and Gynecology, found 30% had a psychological disorder.
Major depressive disorder was found in 10.1% of patients, whereas any depressive disorder was found among 27.2% of patients. Previously reported prevalence rates of depression and depressive symptoms in patients seen by a gynecologist have varied between 11% and 50%, depending on the selection of patients and the diagnostic instruments used. An anxiety disorder was diagnosed in 12% of patients.
Fewer than 10 percent of women in whom depression was detected had received antidepressant therapy before the study began. Taking into account all psychological disorders detected, only 21% had received any form of treatment.
A similar study in the February reaches the same conclusion. Psychological disorders or substance abuse in 38% of an unselected population of women seeking prenatal care for example.
Making the screening tools easier and more convenient is no guarantee that if a disorder is detected it will be followed up and treated. You can’t assume that just because the patient completes the questionnaire that an ob-gyn physician is going to pay attention to it. Many physicians feel it’s something they don’t want to get involved in. There has to be real changes in training and reimbursement and the system in general. There is a lot of evidence that having these questionnaires filled out doesn’t modify physician behavior.
It is clear from current research that one should anticipate a high percentage of depressed women, higher still if they are pregnant, and that early diagnosis is unlikely to occur outside the psychologist’s office.