Primary care physicians' beliefs and practices toward maternal depression

The negative impact of maternal depression on both the mother and her offspring highlight the importance of managing (diagnosing/treating) maternal depression in primary care. Despite this heightened emphasis, many primary care physicians (PCPs) still fail to diagnose and treat maternal depression in their patients. To address this apparent gap between opportunity for care and actual care delivery, the present surveillance study examined the relationships among PCPs' beliefs, knowledge, self-efficacy, and perceived barriers toward and practices related to managing maternal depression.

A total of 232 PCPs (obstetricians, pediatricians, and family medicine practitioners) residing in Southeastern Virginia completed a 60-item survey, by either web or mail in 2006. The 60-item survey contained questions pertaining to demographics, attitudes, beliefs, efficacy, current practices, and perceived barriers regarding the management of maternal depression. Chi-square and one-way ANOVAs analyses of survey items were conducted to compare PCPs' knowledge, beliefs, self-efficacy, perceived barriers, past training toward, and current management practices for maternal depression (i.e., frequency of assessment, referral, consultation, and treatment) across specialties.

Over 90% of physicians reported that it was their responsibility to recognize maternal depression; however, a large percentage of physicians rarely/never assess for depression (40%) or provide a referral (66%). Significant differences in beliefs, perceived barriers, and practices were found across specialties.

These findings will guide the development of future multifaceted intervention strategies to enhance physician skills and practices in managing maternal depression in primary care settings.