Primary Care Pediatricians’ Roles and Perceived Responsibilities in the Identification and Management of Maternal Depression

Kemper, Kathi J.; Kelleher, Kelly J.; Hammond, Cristina S.; Zuckerman, Barry; Dietrich, Allen J.

doi:10.1097/00006254-200305000-00009

Cited by 64 publications

(100 citation statements)

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“…From the perspective of those providing pediatric health care, maternal smoking and depression can be viewed as "sentinel" conditions because they are common and impact many aspects of child health. However, pediatric primary care clinicians understandably report lacking the time, skills, and mandate to treat mothers in a manner consistent with recommended practice guidelines (Oncken et al, 2000, Olson et al, 2002, Perez-Stable et al, 2001, Frankowski and Secker-Walker, 1989, Frankowski et al, 1993). An interim approach for pediatricians may be to develop a referral network of adult health care providers.…”

Section: Implications Of the Findingsmentioning

confidence: 99%

“…As individual conditions, maternal smoking and depression are increasingly being addressed in children's health care (Olson et al, 2002, Zimmer and Minkovitz, 2003, Frankowski and Secker-Walker, 1989, Kemper et al, 1994, Green and Palfrey, 2002. However, in pediatric clinical practice, the relationship between these two maternal risk factors is not always considered.…”

Section: Introductionmentioning

confidence: 99%

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The co-occurrence of smoking and a major depressive episode among mothers 15 months after delivery

Whitaker

Orzol

Kahn

2007

Preventive Medicine

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Objective-To examine the association between maternal smoking 15 months after delivery and the occurrence of a major depressive episode in the prior 12 months.Methods-Data were obtained from the Fragile Families and Child Wellbeing Study, a birth cohort study. In 20 U.S. cities, 4,898 mothers were surveyed at delivery in the years 1998 to 2000. In a survey 15 months later, 4,353 (89%) of the mothers reported their smoking behavior and symptoms of a major depressive episode during the prior 12-months.Results-At the follow-up survey, 26.6% of mothers reported that they were current smokers and 13.6 % reported that they had symptoms of a major depressive episode during the prior 12 months. After adjusting for sociodemographic characteristics, the prevalence (95% confidence interval) of a major depressive episode was higher among smokers than nonsmokers: 17.7% (15.7%, 19.8%) vs. 12.1% (10.9%, 13.3%). Smoking was also more common among mothers with a major depressive episode than in those without one: 34.0% (30.6%, 37.4%) vs. 25.5% (24.1%, 26.8%). Conclusion-Smokingand depression often co-occur among mothers with infants. This suggests that these conditions should not be diagnosed or treated in isolation from each other and that the care of mothers and children should be integrated.Precis-Among 4,353 mothers assessed 15 months after delivery, the prevalence of depression was 46% higher among smokers and the prevalence of smoking was 33% higher among those with depression.

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Section: Implications Of the Findingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The co-occurrence of smoking and a major depressive episode among mothers 15 months after delivery

Whitaker

Orzol

Kahn

2007

Preventive Medicine

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“…However, a recent study (89) showed that maternal depression was under-recognized by paediatric health care providers. Moreover, Olson et al (90) reported that paediatricians lacked confidence in their ability to diagnose maternal depression and limited their involvement because of incomplete knowledge and training.…”

Section: Role Of the Primary Care Physician/paediatricianmentioning

confidence: 99%

“…Screening questionnaires have been developed and validated specifically to detect postpartum depression (91)(92)(93). Examples of questions that may elicit information about postpartum depression are listed in Table 2 (90,94,95). Once depression is suspected, the paediatrician can give advice and discuss with the mother's physician or make an appropriate referral to psychiatric services.…”

Section: Role Of the Primary Care Physician/paediatricianmentioning

confidence: 99%

Maternal depression and child development

Bernard-Bonnin¹

2004

Paediatrics &Amp; Child Health

233

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“…Recognizing this potential, the American Academy of Pediatrics recommends incorporating screening and referral for maternal depression into routine pediatric practice (14). There is broad consensus that screening for maternal depression in pediatrics is acceptable to most women (15) and many pediatric providers (16), and there is good evidence that routine screening does not necessarily impair clinic efficiency (17)(18)(19)(20)(21). Screening, however, is not sufficient to promote maternal and child well being (22).…”

mentioning

confidence: 99%

Beyond screening: a review of pediatric primary care models to address maternal depression

et al. 2015

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Depression is one of the most debilitating chronic disorders in the United States, affecting 15 million children in homes with depressed mothers, many of whom endure household chaos, inconsistent nurturing, inadequate safety practices, and harsh discipline. Depressed mothers are under diagnosed and undertreated, yet there is broad consensus about the importance of identifying and managing maternal depression, as reflected in recommendations by pediatric and obstetric professional organizations to routinely screen for perinatal depression. Screening was shown to be acceptable to women and most pediatric providers, and adding a screening component need not impair clinic efficiency. Screening, however, is not sufficient, and there are few models in the literature to guide medical practices in implementing successful interventions to identify, treat, and prevent maternal depression, particularly in the pediatric setting. We reviewed the literature and identified six studies that evaluated models for screening and managing mothers' depression in pediatric primary care settings. Some of these interventions have promise, but no studies characterized health outcomes of the depressed mothers and children. We discuss the components of these models, their implementation, and the practice and research needed to create effective pediatrics-based systems to reduce the negative effects of maternal depression on mothers, children, and families.D epression is one of the most debilitating chronic disorders in the United States (1), a fact experienced every day by the 15 million children being raised in homes with depressed mothers (2). Children living with depressed mothers may experience household chaos, inconsistent nurturing, inadequate safety practices, harsh discipline, and child maltreatment (3,4). Compared to nonexposed peers, children of depressed mothers are two to three times more likely to develop psychiatric disorders themselves and to do poorly in school (5-9). Moreover, recent studies suggest that remission of maternal depression is associated with significant improvement in child behavioral and mental health outcomes (10). Children's home, family, and social environments appear to explain the majority of the risk for the intergenerational transmission of depression (11), with genetics contributing less than half of the risk (10,12). It is the immediate family environment, what Bronfenbrenner refers to as "proximal processes, " that powerfully shapes children's neural, cognitive, social, and behavioral development (13). Thus, it is imperative to promote the safety and wellbeing of children living in homes with depressed mothers.According to the 2009 US National Academies of Science review of maternal depression, "Few opportunities exist to identify the vulnerable population of children living in households with one or more parents experiencing depression or to offer prevention and treatment services that can improve the care of the depressed parent in a framework that also offers services for children" (2). The pedi...

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Primary Care Pediatricians’ Roles and Perceived Responsibilities in the Identification and Management of Maternal Depression

Cited by 64 publications

References 0 publications

The co-occurrence of smoking and a major depressive episode among mothers 15 months after delivery

The co-occurrence of smoking and a major depressive episode among mothers 15 months after delivery

Maternal depression and child development

Beyond screening: a review of pediatric primary care models to address maternal depression

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