Perinatal mental health in low-income urban and rural patients: The importance of screening for comorbidities

Katherine A Craemer; Caitlin E Garland; Lauren Sayah; Jennifer Duffecy; Stacie E Geller; Pauline M Maki

doi:10.1016/j.genhosppsych.2023.05.007

Perinatal mental health in low-income urban and rural patients: The importance of screening for comorbidities

Gen Hosp Psychiatry. 2023 Jul-Aug:83:130-139. doi: 10.1016/j.genhosppsych.2023.05.007. Epub 2023 May 11.

Authors

Katherine A Craemer¹, Caitlin E Garland², Lauren Sayah², Jennifer Duffecy³, Stacie E Geller⁴, Pauline M Maki⁵

Affiliations

¹ Center for Research on Women and Gender, College of Medicine, University of Illinois Chicago, Chicago, IL, USA. Electronic address: kcraem2@uic.edu.
² Center for Research on Women and Gender, College of Medicine, University of Illinois Chicago, Chicago, IL, USA.
³ Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, USA.
⁴ Center for Research on Women and Gender, College of Medicine, University of Illinois Chicago, Chicago, IL, USA; Department of Obstetrics and Gynecology, College of Medicine, University of Illinois Chicago, Chicago, IL, USA.
⁵ Center for Research on Women and Gender, College of Medicine, University of Illinois Chicago, Chicago, IL, USA; Department of Obstetrics and Gynecology, College of Medicine, University of Illinois Chicago, Chicago, IL, USA; Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, USA; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.

PMID: 37187032
DOI: 10.1016/j.genhosppsych.2023.05.007

Abstract

Objective: To assess the rates and feasibility of assessing comorbid mental health disorders and referral rates in low-income urban and rural perinatal patients.

Methods: In two urban and one rural clinic serving primarily low-income perinatal patients of color, a computerized adaptive diagnostic tool CAT-MH® was implemented to assess major depressive disorder (MDD), general anxiety disorder (GAD), suicidality (SS), substance use disorder (SUD), and post-traumatic stress disorder (PTSD) at the first obstetric visit and/or 8 weeks postpartum.

Results: Of a total of 717 screens, 10.7% (n = 77 unique patients) were positive for one or more disorders (6.1% one, 2.5% two, 2.1% three or more). MDD was the most common disorder (9.6%) and was most commonly comorbid with GAD (33% of MDD cases), SUD (23%), or PTSD (23%). For patients with a positive screen, referral to treatment was 35.1% overall, with higher rates in urban (51.6%) versus rural (23.9%) clinics (p = 0.03).

Conclusion: Mental health comorbidities are common in low-income urban and rural populations, but referral rates are low. Promoting mental health in these populations requires comprehensive screening and treatment approaches for psychiatric comorbidities and dedication to increase the availability of mental health prevention and treatment options.

Keywords: Anxiety; Comorbidities; Depression; Mental health; Pregnancy; Rural.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety Disorders / diagnosis
Anxiety Disorders / epidemiology
Anxiety Disorders / psychology
Depressive Disorder, Major* / diagnosis
Depressive Disorder, Major* / epidemiology
Depressive Disorder, Major* / psychology
Female
Humans
Mental Health
Pregnancy
Rural Population
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / psychology
Substance-Related Disorders* / diagnosis