Physician reported communication about depression and psychosocial issues during postpartum visits

Objective: Postpartum depression occurs in 13% of women after delivery, making it one of the most common puerperial complications. The purpose of the study was to examine: (1) the extent to which obstetricians/gynecologists and family physicians report discussing depression and other psychosocial issues during postpartum visits, and (2) how physician specialty and gender are related to whether physicians report discussing depression and other psychosocial issues with patients during postpartum visits.
Methods: A survey was sent to a random sample of 600 obstetricians/gynecologists and 600 family practitioners in North Carolina.
Principal Findings: The overall response rate was 42%. Forty-six percent of the responding physicians (N=228) reported that they had seen women for postpartum visits during the past 3 months. Of physicians conducting postpartum visits within this time period, 43% of physicians were almost certain to ask whether the woman felt down, depressed, or hopeless and 27% were almost certain to ask about the woman’s interest in her usual activities. Seventy-nine percent of physicians stated that they were unlikely to use a formal screen for depression. Obstetricians/gynecologists were less likely to ask about a woman’s social support network (OR=0.33, 95% CI=0.14, 0.75), to ask about her relationship with her partner (OR=0.40, 95% CI=0.18, 0.87), and to use a formal depression screen (OR=0.16, 0.04, 0.57) than family practitioners.
Limitations: The study only examined physician self-report of the extent to which they communicated about different issues with women during postpartum visits.
Conclusions: Communication about depression and related psychosocial issues during postpartum visits is substantially limited, likely contributing to the underdiagnosis of this common disorder.