Depression in pregnancy: New study shows preferences for therapy over medication

November 18, 2013, Wolters Kluwer Health

Women with depression in the perinatal period experience a high degree of conflict in deciding whether and how to treat their depression, but strongly prefer treatments other than antidepressant medications, reports a study in the November Journal of Psychiatric Practice.

The preliminary study, led by Cynthia L. Battle, PHD, of the Warren Alpert Medical School of Brown University, Butler Hospital, and Women & Infants' Hospital of Rhode Island, helps to fill the gap in knowledge about women's preferences and decision-making patterns regarding treatment for depression during and after pregnancy.

Women Discuss Preferences and Concerns Regarding Treatment for Perinatal Depression

The researchers performed in-depth interviews with 61 pregnant women at 32 weeks' gestation. Participants were a subset of women enrolled in a longitudinal study focused on understanding the impact of prenatal antidepressant use and prenatal maternal depression on fetal and neonatal outcomes, and about half of the women in the research sample were clinically depressed.

Depressed women participated in further interviews to assess their experiences and preferences regarding depression treatment. Levels of "decisional conflict" related to treatment for depression during pregnancy were assessed as well.

Women with perinatal depression were younger, had lower socioeconomic status, and were more likely to be single than nondepressed participants. Depressed women also had increased levels of anxiety and greater impairment in marital/family relationships—underscoring the need for treatment.

Although about 70 percent of the depressed women received some form of depression treatment during pregnancy, they often reported conflictual feelings concerning decisions during pregnancy. Indeed, one-third experienced a high degree of uncertainty and confusion. Women who were more uncertain about their had higher levels of depression, and were less likely to engage in treatment.

Strong Concerns About Antidepressant Drugs during Pregnancy

Some expressed positive feelings about treatment. However, as in previous studies, women were more likely to prefer non-drug treatments for depression, such as psychotherapy and alternative therapies.

Many women said they would consider using during pregnancy only as a "last resort." Concerns included fear of possible adverse effects on the developing baby, including withdrawal symptoms, premature delivery, and childhood learning problems; feelings of shame, guilt, and confusion about using antidepressants during pregnancy; and the potential for the infant becoming dependent on these medications.

All of the women in the study—regardless of depression status—were asked about their preferences for treatment if they were to experience an episode of postpartum depression. Most said that they would prefer some form of psychotherapy over medication, expressing concerns about possible effects of antidepressant exposure through breast milk. Again, the women strongly preferred alternative treatments.

Previous research has reported women's "general reluctance" to take medications during pregnancy and the postpartum period. This new study was designed to characterize the concerns, preferences, and motivations influencing women's mental health treatment preferences—particularly regarding antidepressant drugs—during the perinatal period.

The results "point to a need for greater decisional support for depressed perinatal women who are grappling with difficult treatment decisions, as well as enhanced support and training for clinicians who provide care for these patients," Dr Battle and colleagues write. They add, "Providing increased psychoeducation as part of the decision-making process may also help patients feel more comfortable with certain treatment options—including antidepressant medications—as information is discussed regarding the known risks and potential benefits in the context of an individual's symptoms and treatment needs."

Given 's concerns about using antidepressants, it's important to increase awareness regarding effective non-drug treatments for depression during pregnancy, Dr Battle and coauthors believe. They call for further studies of all possible options for treatment of perinatal , including medications, specific forms of psychotherapy, and alternative treatments such as yoga, exercise, and light therapy.

Explore further: What's best for depressed pregnant women and their infants?

Related Stories

What's best for depressed pregnant women and their infants?

October 15, 2013
Do the benefits of treating depressed pregnant women with antidepressants outweigh the risks of the drug exposure to their babies in terms of neonatal health and long-term development?

Stopping meds during pregnancy does not increase risk of depression

September 9, 2011
(Medical Xpress) -- Women who discontinue using antidepressants during pregnancy do not appear to have greater risk of having a depressive episode during and after term than those who continue using medications, a new Yale ...

Study explores bipolar in postpartum period

November 8, 2013
Researchers have long connected mood disorders and pregnancy. But a study coming out of Western is boiling down some of the specifics, suggesting women who suffered from depression prior to pregnancy should be monitored for ...

Antidepressants for pregnant moms don't affect infants' growth, research says

March 20, 2013
Selective serotonin reuptake inhibitor (SSRI) antidepressants taken by a woman during pregnancy do not impact her infant's growth over the first year, reports a new study from a Northwestern Medicine scientist.

Antidepressants -- not depression -- increase risk of preterm birth, study shows

May 28, 2012
(Medical Xpress) -- Women who are depressed during pregnancy are not at higher risk of giving birth prematurely than non-depressed women — but those who take antidepressants during pregnancy seem to be, a new study ...

New treatment hope for menopausal depression

August 19, 2013
A trial involving middle-aged Australian women is investigating the use of a hormone treatment for symptoms of menopausal depression.

Recommended for you

Short-course treatment for combat-related PTSD offers expedited path to recovery

January 23, 2018
Symptoms of Post-Traumatic Stress Disorder (PTSD) can be debilitating and standard treatment can take months, often leaving those affected unable to work or care for their families. But, a new study demonstrated that many ...

Priming can negate stressful aspects of negative sporting environments, study finds

January 23, 2018
The scene is ubiquitous in sports: A coach yells at players, creating an environment where winning is the sole focus and mistakes are punished. New research from the University of Kansas shows that when participants find ...

Social and emotional skills linked to better student learning

January 23, 2018
Students with well-developed and adaptive social and emotional behaviours are most likely to excel in school, according to UNSW researchers in educational psychology.

Study of learning and memory problems in OCD helps young people unlock potential at school

January 22, 2018
Adolescents with obsessive-compulsive disorder (OCD) have widespread learning and memory problems, according to research published today. The findings have already been used to assist adolescents with OCD obtain the help ...

People with prosthetic arms less affected by common illusion

January 22, 2018
People with prosthetic arms or hands do not experience the "size-weight illusion" as strongly as other people, new research shows.

Intensive behavior therapy no better than conventional support in treating teenagers with antisocial behavior

January 19, 2018
Research led by UCL has found that intensive and costly multisystemic therapy is no better than conventional therapy in treating teenagers with moderate to severe antisocial behaviour.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.