by Madeline Morr, 27 Feb 2020, Menopause Magazine.
Up to 40% of women may experience symptoms of depression during perimenopause. However, screening for mental health during this transition may not be the main focus of women’s healthcare providers and obstetrician-gynecologists (ob-gyns), according to study results published in Menopause.
Improving training for these clinicians in the diagnosis, treatment, and management of depression, both in residency and later, may improve rates of screening in perimenopause, noted the investigators.
Researchers provided a survey to 500 fellows and junior fellows of the American College of Obstetricians and Gynecologists (ACOG) who were members of the Collaborative Ambulatory Research Network. The survey included questions on demographic information, attitudes about practice and depression, and depression screening and treatment practices. Specifically, physicians were asked about their familiarity and confidence in screening for and diagnosing depression and other mental health concerns in perimenopausal women.
Of the 500 surveys deployed, 197 were included in the final analysis. Female respondents were significantly younger compared with male respondents (51.2 years vs 61.1 years, respectively), were more likely to practice in a university or group as opposed to a solo practice, and were more likely to consider themselves generalists rather than specialists.
A majority of respondents (65.9%) reported screening perimenopausal patients for depression, whereas 34.1% reported that they did not typically do so. Female respondents were more likely than male respondents to report that they typically screen perimenopausal patients for depression (72.4% and 55.4%, respectively). Respondents who practiced in a university (76%), group practice (73.8%), or other (75%) were more likely to say that they screen perimenopausal patients for depression than those who practice in a solo practice or multispecialty group. Personal experience with depression was not significantly related to screening among the whole sample; however, female respondents, but not male respondents, who had personally experienced depression were more likely to report screening patients for depression than were those without personal depression experience (91.3% vs 65.8%, respectively).
Respondents with adequate or comprehensive residency training in treating, recognizing, and diagnosing depression were more likely to screen for depression than were those who reported barely adequate or inadequate training in these areas. Respondents who completed continuing medical education related to depression were more likely to report screening perimenopausal patients for depression.
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Barriers to screening for depressive symptoms in perimenopausal women were time (87.5%), inadequate training (50.6%), and inadequate reimbursement (30.1%). A majority of respondents were confident in their ability to treat depression in perimenopausal women (55.8%), recognize depression (85.7%), diagnose depression (70.4%), and distinguish between depression and anxiety (67.2%).
“With the release of specific screening and treatment guidelines, it is possible that physicians will gain more awareness of depression during perimenopause, and future studies should consider whether these guidelines have impacted physicians’ knowledge and practices,” the authors concluded.
References
- Timur S, Sahin NH. The prevalence of depression symptoms and influencing factors among perimenopausal and postmenopausal women. Menopause. 2010;17:545-551.
- Raglan GB, Schulkin J, Juliano LM, Micks EA. Obstetrician-gynecologists’ screening and management of depression during perimenopause [published online January 13, 2020]. Menopause. doi: 10.1097/GME.0000000000001488
