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

Ford, Elizabeth, Shakespeare, Judy, Elias, Fatin and Ayers, Susan (2016) Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review. Family Practice. ISSN 0263-2136

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Abstract

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.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and teaching. Research
Depositing User: Phoenix Marshall
Date Deposited: 28 Sep 2016 13:09
Last Modified: 13 Mar 2017 11:35
URI: http://sro.sussex.ac.uk/id/eprint/63657

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