Ask the doctors
Q: I went for my usual check-up, and in addition to taking my blood pressure, the medical assistant handed me a form to fill out with nine questions related to my mental health. I’ve never had this happen before. Is this new?
A: Yes, it is new for most people. The U.S. Preventive Services Task Force (USPSTF) has just released an important depression screening recommendation. The USPSTF recommends regular depression screening for all adults, which is a modification from advice originally given in 2009, in which screening was recommended only for clinics or doctors who had adequate support systems to provide mental health care for those who were identified with depression. Since that time, multiple studies have found that mental health care from primary care clinicians works very well, and probably just as well as specialist care from psychiatrists. That isn’t to say we don’t need care from psychiatrists, but rather that not everyone needs a psychiatrist, especially those with mild to moderate depression.
As an obstetrician, I was particularly pleased with the recommendations because they now include pregnant women and those who have recently given birth, 10% of whom suffer from depression. The USPSTF found that treatment with cognitive behavioral therapy improves clinical outcomes in pregnant and postpartum women with depression. While some pregnant women will need medication for serious depression, there are rare but serious risks to the fetus in taking antidepressants, so it is not a decision that women or their obstetricians should take lightly.
— Hope Ricciotti, M.D., and Hye-Chun Hur, M.D., M.P.H.
Editors in Chief, Harvard Women’s Health Watch