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Identifying Maternal Depression in Pediatric Primary Care

Changes Over a Decade

Kerker, Bonnie D. PhD; Storfer-Isser, Amy PhD; Stein, Ruth E. K. MD; Garner, Andrew MD, PhD; Szilagyi, Moira MD; O'Connor, Karen G. BS; Hoagwood, Kimberly E. PhD; Horwitz, Sarah McCue PhD

Journal of Developmental & Behavioral Pediatrics: February/March 2016 - Volume 37 - Issue 2 - p 113–120
doi: 10.1097/DBP.0000000000000255
Original Articles

Objective: Maternal depression affects 10% to 40% of mothers with young children and has negative consequences for children's health and development. The American Academy of Pediatrics (AAP) recommends that pediatricians identify women with maternal depression. The authors examined trends in inquiring about (asking informal questions) or screening for (using a standardized instrument) maternal depression by pediatricians in 2004 and 2013 and identified correlates of usually inquiring/screening to identify maternal depression.

Methods: Data were ascertained from 778 nontrainee pediatricians exclusively practicing general pediatrics who completed the 2004 (n = 457) and 2013 (n = 321) AAP Periodic Surveys. Pediatricians answered questions about physician and practice characteristics, training, attitudes, and inquiring/screening to identify maternal depression. Sample weights were used to reduce nonresponse bias. Weighted descriptive and logistic regression analyses were conducted.

Results: The prevalence of usually inquiring/screening to identify maternal depression increased from 33% to 44% (p < .01). In both years, pediatricians who usually inquired about child/adolescent depression had increased odds of usually inquiring/screening to identify maternal depression. Patient race/ethnicity and training in adult Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for depression were associated with inquiring/screening in 2004, and believing that family screening is within the scope of the pediatrician was associated with inquiring/screening in 2013.

Conclusion: Although inquiring/screening about maternal depression has increased since 2004, less than half of pediatricians usually screen or inquire about maternal depression, representing a missed opportunity to identify depression and manage or refer women for treatment. Further training on the importance of mental and family health to children's health may increase identification of maternal depression in pediatric primary care.

*Nathan Kline Institute of Psychiatric Research, Orangeburg, NY;

Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY;

Statistical Research Consultants, LLC, Schaumburg, IL;

§Albert Einstein College of Medicine/Children's Hospital at Montefiore, New York, NY;

Case Western Reserve University, School of Medicine, Cleveland, OH;

University of California at Los Angeles, Los Angeles, CA;

**American Academy of Pediatrics, Elk Grove Village, IL;

††New York State Office of Mental Health, Albany, NY.

Address for reprints: Bonnie D. Kerker, PhD, Department of Child and Adolescent Psychiatry, New York University School of Medicine, 1 Park Avenue, 7th Floor, New York, NY 10016; e-mail:

American Academy of Pediatrics supported this research. NIMH P30 MH09 0322 (PI K.E.H.) supported A. Storfer-Isser, K. E. Hoagwood, and S. M. Horwitz's participation in this research.

Disclosure: The authors declare no conflict of interest.

See the related commentary “Postpartum Depression Screening by Pediatricians: Time to Close the Gap” by Michael Yogman on page 157.

Received September , 2015

Accepted November , 2015

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