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Obstetrician-Gynecologists and Women's Mental Health: Findings of the Collaborative Ambulatory Research Network 2005–2009

Leddy, Meaghan A. MA*; Lawrence, Hal MD; Schulkin, Jay PhD

Obstetrical & Gynecological Survey: May 2011 - Volume 66 - Issue 5 - p 316-323
doi: 10.1097/OGX.0b013e31822785ee

Background: Many mental illnesses are more prevalent in women than men (e.g., depression). Obstetrician-gynecologists (ob-gyns) are frequent medical contacts for women, and so can play an important role in screening for mental illness.

Methods: This review summarizes studies published between 2005 and 2009 by the Research Department of the American College of Obstetricians and Gynecologists that encompass depression, anxiety, and eating disorders (EDs).

Results: Ob-gyns were more accurate in identifying depression than anxiety. Treatment with antidepressants was reported as a course of action twice as often as referral to a mental health professional. Physicians were moderately confident that they could recognize anxiety, but were less confident regarding treatment. One-fifth routinely screen pregnant patients for anxiety; level of interest in anxiety was the only significant predictor of screening rates. The main barriers to anxiety screening in pregnancy were time constraints and perceived inadequate training. Almost all believed EDs can harm pregnancy outcome, although few ask about ED histories. Only half view assessment of ED as within routine ob-gyn practice. Those who self-identify as primary care providers, and those who more strongly believe EDs can harm pregnancy outcomes, agreed more strongly that ED assessment is within their role. Ob-gyns perceived training regarding EDs to be poor. Knowledge of risks associated with EDs was low.

Conclusions: Ob-gyns view mental health issues as important topics; however, they are not confident in their abilities to diagnose these conditions and are also concerned about the adequacy of their training. Additional training could prepare ob-gyns to incorporate mental health screening into their practices.

Target Audience: Obstetricians & Gynecologists, Family Physicians.

Learning Objectives: After completion of this educational activity, the obstetrician/gynecologists should be better able to evaluate their role relative to diagnosing and treating mental illness; state the negative consequences and signs of major depressive disorder, anxiety, eating disorder, and premenstrual dysphoric disorder (PMDD) in women; examine their peers' attitudes, referral patterns, and preferred treatment methods for mental disorders; and prevent negative health consequences for women and babies resulting from mental illnesses.

*Doctoral Candidate, Department of Psychology, American University, Washington, DC, and *Research Assistant, †Executive Vice President, ‡Director of Research, Department of Research, American College of Obstetricians and Gynecologists, Washington, DC

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Supported by Grant no. R60MC 05674 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, and Department of Health and Human Services (HHS).

Correspondence requests to: Jay Schulkin, PhD, Director of Research, American College of Obstetricians and Gynecologists, 409 12th Street, SW, Washington, DC 20024. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.