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Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review

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posted on 2023-06-09, 03:09 authored by Elizabeth FordElizabeth Ford, Judy Shakespeare, Fatin Elias, Susan Ayers
Background: Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs’ routine recognition, diagnosis and management of anxiety and depression in the perinatal period. Method: A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs’ or Family Physicians’ assessment, recognition and management of anxiety or depression in pregnancy or postpartum. Results: Thirteen papers, reporting ten studies, were identified from the US, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counselling by GPs and referrals to specialists were common in the postnatal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training. Conclusions: Data on GPs’ awareness and management of perinatal depression was sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices. Keywords: postnatal depression, general practice, pregnancy, mental health, systematic review.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Family Practice

ISSN

0263-2136

Publisher

Oxford University Press

Issue

1

Volume

34

Page range

11-19

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2016-09-28

First Open Access (FOA) Date

2017-09-23

First Compliant Deposit (FCD) Date

2016-09-27

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