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It Is Time for Routine Screening for Perinatal Mood and Anxiety Disorders in Obstetrics and Gynecology Settings

Accortt, Eynav Elgavish PhD*; Wong, Melissa S. MD

Obstetrical & Gynecological Survey: September 2017 - Volume 72 - Issue 9 - p 553–568
doi: 10.1097/OGX.0000000000000477

Importance Women are 2 to 3 times more likely than men to experience depression in their lifetime, and the greatest risk occurs during the reproductive years. As an obstetrics and gynecology physician or provider, you will likely encounter women who are at risk of development or relapse of a mental disorder during this vulnerable time.

Objective The aim of this review is to examine theory and research on mood and anxiety disorders during the perinatal period with an emphasis on screening recommendations.

Evidence Acquisition A PubMed and PsycINFO search for English-language publications about perinatal mood and anxiety disorders and screening was performed and included studies on subtopics.

Results The literature reviewed suggests that perinatal mood and anxiety symptoms are prevalent and have significant consequences, and best practices for early detection are through routine depression and anxiety screening in the obstetrics setting. This includes overcoming barriers to care and use of liaison services to potentially reduce risk.

Conclusions and Relevance High-quality prenatal care systems should develop the capacity for depression and anxiety risk assessment and treatment. Providers should routinely screen using validated screening tools, provide maternal mental health education, and be aware of the various medical, psychological, and complementary approaches for treating mood and anxiety disorders, to best guide and refer patients. The use of this practice will increase the quality of life in pregnant women with depression and anxiety and may help to reduce the likelihood of adverse birth outcomes, postpartum mental health problems, and adverse effects on offspring.

Target Audience Obstetricians and gynecologists, family physicians.

Learning Objectives After completing this activity, the learner should be better able to name 3 adverse birth outcomes related to prenatal symptoms of depression and anxiety; identify symptoms, prevalence, and consequences of depression and anxiety in pregnancy and postpartum; and contrast and apply reliable, valid, and widely used screening tools to assess for depression and anxiety and practice appropriate referral for this population.

*Assistant Professor and †Fellow, Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA

All authors, faculty, 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.

Correspondence requests to: Eynav Elgavish Accortt, PhD, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8635 W 3rd St, 280 West Tower, Los Angeles, CA 90048. E-mail:

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.