High Prevalence of Peripartum Depression Among Physician Mothers: A Cross-Sectional Study
To the Editor: Although accurate estimates are difficult to obtain, peripartum depression is experienced by approximately 10%−15% of women in the general population (1), and it has severe consequences for mother and child. Female physicians are reluctant to divulge or seek mental health care (2); however, peripartum depression among female physicians has not been well described. We examined the prevalence of peripartum depression, treatments accessed, and stigmatizing views among female physicians.
Survey participants were recruited from the Physician Moms Group, an online Facebook community of female physicians who are mothers, through posts on the group’s home page containing a link to an anonymous survey. The survey included self-report questions about history of peri- or postpartum depression, treatments received, and whether participants held any personal stigmas regarding mental health problems among physicians (3). In-depth methodology has been described previously (4).
The proportion of participants reporting peripartum depression (combined peri- and postpartum depression) was examined across racial-ethnic and professional characteristics. Logistic regression models estimated odds ratios and corresponding 95% confidence intervals (CI) for prevalence of peripartum depression, receipt of treatment, and endorsement of stigma. Covariates were selected a priori based on associations in the literature.
Of the 5,698 physician mothers who completed the survey, 74% were white, 13% were Asian, 8% were Hispanic, and 5% were black. We found a high overall prevalence of peripartum depression (25%). Among those with peripartum depression, there was low treatment seeking: 34% reported pharmacotherapy, 25% received psychotherapy, and 40% received either treatment. Nineteen percent used only self-care activities (e.g., exercise).
Racial differences in treatment seeking were noted. In adjusted analysis, black physicians had lower odds of reported peripartum depression compared with white physicians (odds ratio=0.66, 95% CI=0.44–0.97). Asian physicians had lower odds of receiving any formal treatment (odds ratio=0.48, 95% CI=0.32–0.73).
The majority of physicians (74%) endorsed at least one stigmatizing belief about physicians with mental health conditions, and endorsing this view was independently associated with decreased odds of receiving peripartum depression treatment (odds ratio=0.48, 95% CI=0.37–0.65) (Table 1).
History of Peri- or Postpartum Depression (N=1,428) | Psychotropic Therapyb | Psychotherapyb | Any Formal Treatmentb,c | |||||
---|---|---|---|---|---|---|---|---|
Characteristic | Odds Ratio | 95% CI | Odds Ratio | 95% CI | Odds Ratio | 95% CI | Odds Ratio | 95% CI |
Raced | ||||||||
White (reference) | — | — | — | — | ||||
Black | 0.66 | 0.44–0.97 | 0.67 | 0.30–1.50 | 0.98 | 0.43–2.22 | 0.78 | 0.37–1.66 |
Asian | 0.85 | 0.69–1.04 | 0.42 | 0.27–0.66 | 0.62 | 0.39–0.98 | 0.48 | 0.32–0.73 |
Othere | 1.21 | 0.92–1.60 | 0.55 | 0.32–0.95 | 0.76 | 0.43–1.35 | 0.58 | 0.35–0.96 |
Ethnicityd | ||||||||
Not Hispanic or Latino (reference) | — | — | — | — | ||||
Hispanic or Latino | 1.02 | 0.79–1.32 | 0.98 | 0.61–1.57 | 1.04 | 0.63–1.72 | 1.00 | 0.63–1.58 |
Endorses any stigmatized viewsf | (Not examined for prevalence) | 0.48 | 0.36–0.64 | 0.71 | 0.52–0.97 | 0.48 | 0.37–0.65 |
Our study demonstrates that peripartum depression is common among physician mothers. Less than half of the women in our study received formal treatment, with Asian subpopulations least likely to receive treatment. Most of these women reported stigmatizing attitudes regarding mental health conditions, and stigma was associated with decreased treatment utilization. Although our study is limited by reliance on self-reported depression instead of a validated instrument, only a third of women with instrument-validated depression will self-report depression (5). This study underscores the need for further research into the prevalence of peripartum depression, and barriers to treatment, among physician mothers.
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