Unipolar major depression in pregnant women: General principles of treatment
- Sophie Grigoriadis, MD, MA, PhD, FRCPC
Sophie Grigoriadis, MD, MA, PhD, FRCPC
- Associate Professor of Psychiatry
- University of Toronto
- Sunnybrook Health Sciences Centre
- Section Editors
- Peter P Roy-Byrne, MD
Peter P Roy-Byrne, MD
- Editor-in-Chief — Psychiatry
- Section Editor — Depressive Disorders
- Professor of Psychiatry and Behavioral Sciences
- University of Washington School of Medicine
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
Unipolar major depression is common in pregnant women, but is often not treated . In a nationally representative survey in the United States that identified pregnant women with major depression, only 50 percent received treatment . Untreated disease causes maternal suffering and is associated with poor nutrition, comorbid substance use disorders, poor adherence with prenatal care, postpartum depression, impaired relationships between the mother and her infant and other family members, and an increased risk of suicide [3,4].
Barriers to treatment of antenatal depression include cost, opposition to treatment (eg, fear of exposing the fetus to antidepressant medication or lack of interest in psychotherapy), unavailability of psychotherapy, and stigma [3,4]. In addition, many clinicians are reluctant to use pharmacotherapy because they lack sufficient expertise , and the large literature is often inconsistent .
This topic reviews the general principles of treating antenatal unipolar major depression. Other topics discuss choosing a specific treatment for antenatal major depression; the risks of antidepressants during pregnancy; and the epidemiology, clinical features, assessment, and diagnosis of antenatal depression.
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