Decision making for depression treatment during pregnancy and the postpartum period

Authors

  • Sapana R. Patel Ph.D.,

    Corresponding author
    1. New York State Psychiatric Institute, Columbia University, College of Physicians and Surgeons, New York, New York
    • Department of Clinical Psychology (in Psychiatry), College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, Anxiety Disorders Clinic & Hispanic Treatment Program, 1051 Riverside Drive, Unit ♯69, New York, NY 10032
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  • Katherine L. Wisner M.D. M.S.

    1. Women's Behavioral HealthCARE, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Abstract

Background: To explore women's perspectives about the treatment decision-making process for depression during pregnancy and after birth. Method: One hundred pregnant and postpartum women completed an anonymous web-based surveys regarding treatment decision making for depression. Results: Survey data reveal that most women in this sample prefer an active collaborative role in treatment decision making for depression. Sixty-five percent of the sample made a decision for treatment of their major depressive disorder, including a decision for no treatment, and 34% reported not having made a decision or feeling unsure about their decision. More than half of the sample preferred combination treatment with medications and counseling (55%) followed by counseling (22%), no treatment (8%), and medications (8%). Overall, respondents in this sample had low levels of decisional conflict (uncertainty) with younger women in the sample reporting higher levels of decisional conflict. Conclusions: Treatment decision making for depression during the perinatal period is complex. Asking women about their preferences for participation in decision making, their treatment preferences and their decision making needs during the clinical encounter may lead to improved communication, decision making and quality of care. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.

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