Doctors fail to diagnose depressed mothers

Lorna Duckworth Health Correspondent
Tuesday 27 August 2002 19:00 EDT
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Three out of four women who suffer post-natal depression are neither diagnosed nor treated, putting them at risk of long-term mental illness, a report warns today.

Most women assume they will recover naturally and do not realise that postnatal depression can develop into a "chronic and recurring illness", according to the market analysts Datamonitor.

Doctors are also reluctant to prescribe anti-depressants because of concerns that the medication will affect the infant through breast milk, the research says.

Nearly 80 per cent of mothers experience a short period of mild depression, often known as "baby blues", a few days after giving birth. This normally amounts to weepiness, feeling emotional, anxious or extremely tired.

But 10 to 15 per cent of mothers suffer serious depression within three months of their baby's delivery. A few will need hospital treatment and up to 50 women annually commit suicide in the year after giving birth.

The report's author, Nick Alcock, an analyst specialising in depression, said that only one in four cases of post-natal depression were ever diagnosed, while the remaining 75 per cent of women suffered in silence. "This lack of effective diagnosis and treatment presents a huge danger to the potential mental health of women suffering from postnatal depression," his report says.

"It can lead on to a life of chronic depression if patients remain untreated, which can impact not just that patient, but the development of the infant and the family unit as a whole."

Studies had shown that the risk of developing psychosis in the post-natal period increased 14.5 times and research involving 35,000 births in the US indicated that women had a seven-fold higher risk of being admitted to a psychiatric hospital within three months of delivery.

Aside from the health of the mother, Mr Alcock said that untreated depression also had a negative effect on the development of infants.

But the condition had "not been taken seriously enough" by some health care professionals and drugs manufacturers had failed to provide enough data about the effectiveness of anti-depressants.

Experts in childbirth say that the drugs can help to lift a woman's mood, reduce anxiety and restore normal sleep patterns. But Mr Alcock said there was little published research to show that.

He called for a wide-ranging trial, involving a number of drugs, to ascertain their side-effects and determine the best treatment for nursing mothers.

"Anti-depressant manufacturers need to outline not just the safety, but the efficacy of their drugs for this section of the depression patient population, as well as developing marketing strategies which reach non-psychiatric secondary care specialists" he said.

Screening for post-natal depression should also be made routinely available and doctors should ensure that patients who need medication continue to take their tablets for six months rather than just six weeks.

"If these recommendations are enacted, then post-natal depression will become a more accepted and treated illness. Otherwise it will remain an under-treated illness which affects thousands of women in the UK alone."

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