Obstetrician-gynecologists' knowledge, attitudes and practices regarding major depressive disorder

Obstetrician-gynecologists (ob-gyns) provide depression screening and treatment, but these practices could be improved. This study investigated the use of depression screening tools and treatment of adolescents with depressive symptoms.

Surveys were sent to 220 members of the American College of Obstetricians and Gynecologists (ACOG) who had responded to a survey on depression in the past two years. Response rate was 66% (n = 145). Questions included those related to standardized depression screening, antidepressant prescribing behavior, use of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) and knowledge of adolescent depression.

A total of 40% use standardized screening tools for depression with 46% using the Beck Depression Inventory-II and only 5% using the Patient Health Questionnaire-2 (PHQ-2). The majority (89%) of ob-gyns do not employ the DSM-IV to confirm a diagnosis of major depressive disorder. Of the ob-gyns indicating treating depression with antidepressants, 97% prescribe selective serotonin reuptake inhibitors. Only 19 respondents do not prescribe antidepressants, and instead refer depressed patients to mental health specialists. Most (79%) ob-gyns identified sexual problems as the primary side effect deterring prescribing of antidepressant medication. Ob-gyns were fairly accurate at estimating the prevalence of adolescent depression.

Ob-gyns are not utilizing the recommended validated resources such as the DSM-IV or PHQ-2 for diagnosis of depression or prior to prescribing antidepressants.