Published online March 1, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 444-454 (doi:10.1542/10.1542/peds.2006-0765)
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ARTICLE

Factors Associated With Identification and Management of Maternal Depression by Pediatricians

Amy M. Heneghan, MDa, Linda H. Chaudron, MD, MSb,c,d, Amy Storfer-Isser, MSe, Elyse R. Park, PhDf, Kelly J. Kelleher, MD, MPHg, Ruth E. K. Stein, MDh, Kimberly Eaton Hoagwood, PhDi, Karen G. O'Connor, BSj and Sarah McCue Horwitz, PhDa,e

a Departments of Pediatrics
e Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio
b Departments of Psychiatry
c Pediatrics
d Obstetrics and Gynecology, University of Rochester, Rochester, New York
f Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
g Department of Pediatrics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio
h Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York
i Department of Psychiatry, Columbia University, New York, New York
j Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois

OBJECTIVE. We sought to identify characteristics of pediatricians that were associated with identification or management (referral and/or treatment) of mothers with depression.

METHODS. A cross-sectional survey was mailed to a random sample of 1600 of the 50818 US nonretired members of the American Academy of Pediatrics. Overall, 832 responded, with 745 responses from nontrainee members. The 662 fellow nontrainee members who engaged in direct patient care and completed information on identifying, referring, and treating maternal depression were included in the analyses.

RESULTS. A total of 511 of 662 respondents reported identifying maternal depression; of those who reported identifying maternal depression, 421 indicated they referred and 29 that they treated maternal depression in their practices. Pediatricians who are older, work in practices that provide child mental health services, see primarily (≥75%) white patients, use ≥1 method to address maternal depression, agree that pediatricians should be responsible for identifying maternal depression, think that maternal depression has an extreme effect on children's mental health, and are attitudinally more inclined to identify or manage maternal depression had significantly higher odds of reporting identification of maternal depression. Positive correlates of identification and management of maternal depression included practicing in the Midwest, using ≥1 method to address maternal depression, working in a practice that provides child mental health services, thinking that caregiving problems attributable to maternal health have an extreme effect on children's physical health, having attitudes that are more inclined to identify and to manage maternal depression, and usually inquiring about symptoms routinely to identify maternal depression.

CONCLUSIONS. Pediatricians' practice characteristics and attitudes are associated with their identification and management of mothers with depression.

Key Words: maternal depression • pediatrician • practice patterns

Abbreviations: AAP—American Academy of Pediatrics • OR—odds ratio • CI—confidence interval

Accepted Oct 20, 2006.


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