Addressing depression in obstetrics/gynecology practice.

Efforts to improve the care of depression in primary care patients have largely ignored the potential of obstetrics/gynecology (OB/GYN) practices. We describe feasibility studies of a depression screening and care management intervention in three diverse OB/GYN practices. Patients were screened using the Patient Health Questionnaire. A depression care manager offered education and referral assistance to women who screened positive for depression. The prevalence of depression was higher in the hospital clinic (20.2%, 47/233) than the suburban clinic (10.7%, 8/75) or the office practice (8.2%, 48/583). Seventy-two women participated in the care management intervention. Patient satisfaction with the intervention was high and at 1-month follow-up, 31.9% of patients had kept or scheduled a new mental health appointment. Depression interventions developed in primary care can be successfully adapted for use with patients in OB/GYN practices. Additional modifications, particularly efforts to improve coordination of care with both general medical and mental health providers, are needed.