21 Feb USPSTF Recommends Interventions to Prevent Perinatal Depression
MedicalResearch.com Interview with:
Dr. Karina Davidson, PhD
Professor of Behavioral Medicine (in Medicine and Psychiatry)
Executive Director, Center for Behavioral Cardiovascular Health
Columbia University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Perinatal depression, which includes depression that develops during pregnancy or after childbirth, is one of the most common complications of pregnancy and the postpartum period, affecting as many as 1 in 7 pregnant women. The Task Force found that counseling can help those who are at increased risk of developing perinatal depression, and clinicians should provide or refer pregnant and postpartum individuals who are at increased risk to counseling. Clinicians can determine who might be at increased risk of perinatal depression by looking at someone’s history of depression, current depressive symptoms, socioeconomic risk factors, recent intimate partner violence, and other mental-health related factors.
MedicalResearch.com: What should readers take away from your report?
Response: This new recommendation seeks to prevent perinatal depression in at-risk individuals before it develops, which is an important addition to current efforts to identify and treat it after it develops.
Counseling can prevent perinatal depression and reduce the severity of depressive symptoms in people who are pregnant and postpartum, ultimately improving the quality of life for the mother and the health of the baby. The Task Force found the most beneficial types of counseling are cognitive behavioral therapy (CBT), which addresses negative thoughts and increases positive activities, and interpersonal therapy (IPT), which focuses on an individual’s relationships with other people to improve communication and address problems that contribute to depression.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: There are several areas where further research could address important gaps, including figuring out the best way to identify those at increased risk of perinatal depression. The Task Force also found that we do not yet have enough evidence on non-counseling interventions including physical activity, education, medications, dietary supplements, and health systems interventions, and we need more research to know about whether these interventions can help prevent perinatal depression.
Finally, the Task Force is calling for more evidence to determine whether the counseling interventions CBT and IPT are also effective for lower-risk mothers.
MedicalResearch.com: Is there anything else you would like to add?
Response: We recognize there may be barriers for clinicians to implement this recommendation due to availability of mental health services for some patients. The Substance Abuse and Mental Services Health Administration (SAMHSA) provides resources for locating mental health services in a patient’s area. Some cognitive behavioral therapy programs (e.g., Mothers and Babies program) also provides web-based resources for families and clinicians.
O’Connor E, Senger CA, Henninger ML, Coppola E, Gaynes BN. Interventions to Prevent Perinatal Depression: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA.2019;321(6):588–601. doi:10.1001/jama.2018.20865
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Last Updated on February 21, 2019 by Marie Benz MD FAAD