Published online August 1, 2007
PEDIATRICS Vol. 120 No. 2 August 2007, pp. 449-450 (doi:10.1542/peds.2007-1320)

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LETTER TO THE EDITOR

Implementing Maternal Depression Screening: In Reply

Howard Dubowitz, MD, MS
Division of Child Protection
Department of Pediatrics

Wendy Lane, MD, MPH
Susan Feigelman, MPH
Department of Pediatrics
University of Maryland School of Medicine
Baltimore, MD 21201

We mostly agree with the excellent points raised by Kemper et al in response to our recent article on screening for depression.¹ It seems clear that screening for maternal depression is feasible in pediatric primary care. The availability of a very brief screen should help. We support the need for improved educational efforts to help residents and pediatricians feel competent and comfortable with briefly addressing adult depression and related issues. This was part of our study and, hopefully, will soon be reported.

We also agree with Kemper et al regarding the need for research on ways to optimize screening, including the role of financial incentives. However, there remains the question of whether screening in pediatric settings leads to increased mental health intervention and diminished depression. It seems important to demonstrate this and other potential outcomes before advocating large-scale implementation of any new screen or intervention. This, too, was part of our study, and we hope to publish the findings before long.

Pediatricians face real challenges in reasonably covering the pile of issues on their plate. There are daily pressures to move rapidly. Even pediatricians who fully recognize the importance of psychosocial issues, such as maternal depression, to children's health and well-being grapple with incorporating these issues into their busy practice. Thus, the broader questions being raised here include: (1) What should be priorities in pediatric primary care? (2) What evidence should we use and seek to guide policy and practice in this area? (3) What are optimal strategies for efficiently and effectively using the rich opportunities provided by primary care?

We share the concern of Kemper et al regarding maternal mental health and its impact on children, and we agree on the need to examine ways to learn more on how best to incorporate this issue into pediatric primary care practice.

REFERENCE

1. Dubowitz H, Feigelman S, Lane W, et al. Screening for depression in an urban pediatric primary care clinic. Pediatrics. 2007;119 :435 –443[Abstract/Free Full Text]

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PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics

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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dubowitz, H. Articles by Feigelman, S. Search for Related Content PubMed Articles by Dubowitz, H. Articles by Feigelman, S. Related Collections Office Practice Social Bookmarking                         What's this?