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Increasing Diagnosis and Treatment of Perinatal Depression in Latinas and African American Women: Addressing Stigma Is Not Enough

Published:February 19, 2018DOI:https://doi.org/10.1016/j.whi.2018.01.003
      Perinatal depression (PND), a major depressive episode during pregnancy and the first postpartum year (
      American Psychiatric Association
      Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
      ,
      • Gavin N.I.
      • Gaynes B.N.
      • Lohr K.N.
      • Meltzer-Brody S.
      • Gartlehner G.
      • Swinson T.
      Perinatal depression: A systematic review of prevalence and incidence.
      ), is estimated to occur in 12% to 19% of the general U.S. population (
      • Gavin N.I.
      • Gaynes B.N.
      • Lohr K.N.
      • Meltzer-Brody S.
      • Gartlehner G.
      • Swinson T.
      Perinatal depression: A systematic review of prevalence and incidence.
      ,
      • O'Hara M.W.
      • McCabe J.E.
      Postpartum depression: Current status and future directions.
      ). However, rates of PND are substantially higher among immigrant and U.S.-born Latinas living in the United States at 11% to 50% (
      • Kuo W.-H.
      • Wilson T.E.
      • Holman S.
      • Fuentes-Afflick E.
      • O'Sullivan M.J.
      • Minkoff H.
      Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities.
      ,
      • Lara M.A.
      • Le H.N.
      • Letechipia G.
      • Hochhausen L.
      Prenatal depression in Latinas in the US and Mexico.
      ). Latinas are an important group because of their high fertility rates (
      • Passel J.S.
      • Livingston G.
      • D'Vera C.
      Explaining why minority births now outnumber White births.
      ) and high psychosocial risk factors, such as high rates of poverty (
      • Lara-Cinisomo S.
      • Girdler S.S.
      • Grewen K.
      • Meltzer-Brody S.
      A biopsychosocial conceptual framework of postpartum depression risk in immigrant and US-born Latina mothers in the United States.
      ). Another vulnerable group is African American women, whose estimates of PND range between 7% and 28% (
      • Beeghly M.
      • Olson K.L.
      • Weinberg M.K.
      • Pierre S.C.
      • Downey N.
      • Tronick E.Z.
      Prevalence, stability, and socio-demographic correlates of depressive symptoms in black mothers during the first 18 months postpartum.
      ,
      • Melville J.L.
      • Gavin A.
      • Guo Y.
      • Fan M.-Y.
      • Katon W.J.
      Depressive disorders during pregnancy: Prevalence and risk factors in a large urban sample.
      ,
      • Rich-Edwards J.W.
      • Kleinman K.
      • Abrams A.
      • Harlow B.L.
      • McLaughlin T.J.
      • Joffe H.
      • Gillman M.W.
      Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice.
      ). Much like Latinas, African American women experience increased rates of economic hardship and other psychosocial stressors that increase their risk of PND (
      • O'Hara M.W.
      • McCabe J.E.
      Postpartum depression: Current status and future directions.
      ). Given the complex psychosocial risk factors among these groups, increased efforts to diagnose and treat Latinas and African American women are needed.
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      Biography

      Sandraluz Lara-Cinisomo, EdM, PhD, is Assistant Professor, University of Illinois at Urbana-Champaign. Her research focuses on mental health disparities in racially and ethnically diverse women and military populations. She is studying the neural substrates of pain processing in postpartum depression.

      Biography

      Crystal T. Clark, MD, MSc, is Assistant Professor, Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine. She focuses on mood and anxiety disorders across the reproductive lifecycle. Her research focuses on dosing lamotrigine and lithium in pregnancy.

      Biography

      Jayme Wood, MS, completed a Bachelor of Science in Biology at the University of North Carolina at Chapel Hill and a Master of Science in Bioarcheology and Forensic Anthropology at University College London. She is pursuing a medical degree.