The Obstetrician–Gynecologist's Role in Detecting, Preventing, and Treating Depression
We applaud Bhat et al1 for their commentary on the role of obstetrician–gynecologists in detection, prevention, and treatment of depression, and we applaud the Green Journal for publishing it. The authors point out the devastating public health and family-life effects of untreated depression. Their emphasis on screening at routine intervals and at critical periods, and on screening adolescents as a group at especially high risk for mood disorders and suicide, extends beyond the current common practice in obstetrics and gynecology. Although including the Diagnostic and Statistical Manual of Mental Disorders-5 criterion for diagnosis of depression, the authors recommend using validated screening tools in busy obstetrics and gynecology practices, including the Patient Health Questionnaire 9 and the Edinburgh Postnatal Depression Scale,2 both of which are available online.
The authors recognize the limitations of psychotropic medications alone and the essential role of integrated depression treatment programs for management of mood disorders. However, the use of integrated psychotherapy programs in the United States is currently limited owing to issues of access, cost, inconsistent coverage by health insurance providers, and skepticism toward mental health services. As an alternative, we recommend using authoritative self-help books (bibliotherapy)3–5 as well as regular exercise for management of mild-to-moderate mood disorders and monitoring progress and referring to professionals when necessary.