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Presenting symptoms of women with depression in an obstetrics and gynecology setting.

Abstract：

OBJECTIVE:To describe the presenting symptoms of women with depression in two obstetrics and gynecology clinics, determine depression diagnosis frequency, and examine factors associated with depression diagnosis. METHODS:Data were extracted from charts of women screening positive for depression in a clinical trial testing a collaborative care depression intervention. Bivariate and multivariable analyses examined patient factors associated with the diagnosis of depression by an obstetrician-gynecologist (ob-gyn). RESULTS:Eleven percent of women with depression presented with a psychologic chief complaint but another 30% mentioned psychologic distress. All others noted physical symptoms only or presented for preventive care. Ob-gyns did not identify 60% of women with a depression diagnosis. Depression severity was similar in women who were or were not diagnosed by their ob-gyns. Bivariate analyses showed four factors significantly associated with depression diagnosis: reporting a psychologic symptom as the chief complaint or associated symptom (72% compared with 18.6%, P<.001), younger age (35.5 years compared with 40.8 years, P<.005), being within 12 months postpartum (13.9% compared with 2.8%, P<.005), and a primary care-oriented visit (72% compared with 30%, P<.001). Multivariable analysis showed that reporting a psychologic symptom (adjusted odds ratio [OR] 8.90, 95% confidence interval [CI] 4.15-19.10, P<.001), a primary care oriented visit (adjusted OR 2.46, 95% CI 1.14-5.29, P=.03), and each year of increasing age (adjusted OR 0.96, 95% CI 0.93-0.96, P=.02) were significantly associated with a depression diagnosis. CONCLUSION:The majority of women with depression presented with physical symptoms; most women with depression were not diagnosed by their ob-gyn, and depression severity was similar in those diagnosed and those not diagnosed. LEVEL OF EVIDENCE:III.

journal_name

Obstet Gynecol

journal_title

Obstetrics and gynecology

authors

Cerimele JM,Vanderlip ER,Croicu CA,Melville JL,Russo J,Reed SD,Katon W

doi

10.1097/AOG.0b013e31829999ee

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

313-318

issue

2 Pt 1

eissn

0029-7844

issn

1873-233X

pii

00006250-201308000-00019

journal_volume

122

pub_type

杂志文章

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Presenting symptoms of women with depression in an obstetrics and gynecology setting.