Wittenberg Madeleine F, Milliren Carly E, Waddicor Kathleen, Fitzgerald Shannon L
Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, USA.
Biostatistics and Research Design Center, Boston Children's Hospital, USA.
Clin Child Psychol Psychiatry. 2025 Jul;30(3):683-698. doi: 10.1177/13591045251341007. Epub 2025 May 15.
PurposeAdolescence and pregnancy are sensitive periods for the development or worsening of anxiety and/or depression. Pediatric clinicians often diagnose pregnancy, but little is known about the assessment and treatment of anxiety and/or depression during this sensitive period.MethodsWe completed a retrospective chart review of patients who presented to an Adolescent/Young Adult Medicine clinic between April 2018 and March 2023 with a positive pregnancy test. Investigators reviewed medical records and abstracted patient data by unique pregnancy ( = 318), including demographic characteristics, pregnancy-related factors, mental health diagnoses, and service use.ResultsOf the pregnancies reviewed, 135 (42.5%) had a diagnosis of anxiety and/or depression while 183 (57.6%) had neither. Overall, 28 (8.8%) had anxiety, 68 (21.4%) had depression only, and 39 (12.3%) had both anxiety and depression. Mental health was discussed during 62.6% of visits though patients with prior diagnoses of anxiety and/or depression ( < .001) were more likely to be assessed. Few patients were in therapy (6.9%) or taking psychiatric medication (8.5%). A higher proportion of those with depression identified as Black and a higher proportion of those with both anxiety and depression identified as White ( < .001).DiscussionWe highlight the need to assess for anxiety and depression in all pregnant adolescents/young adults. We encourage future research investigating patient preferences for mental health supports and strengthening of clinical programs that seek to treat and understand anxiety/depression in this unique population.
目的
青春期和孕期是焦虑和/或抑郁发展或加重的敏感期。儿科临床医生经常诊断出怀孕情况,但对于这一敏感期内焦虑和/或抑郁的评估与治疗却知之甚少。
方法
我们对2018年4月至2023年3月期间到青少年/青年医学诊所就诊且妊娠试验呈阳性的患者进行了回顾性病历审查。研究人员通过唯一的妊娠标识(n = 318)审查病历并提取患者数据,包括人口统计学特征、与妊娠相关的因素、心理健康诊断以及服务使用情况。
结果
在审查的妊娠病例中,135例(42.5%)被诊断为焦虑和/或抑郁,而183例(57.6%)既无焦虑也无抑郁。总体而言,28例(8.8%)有焦虑症,68例(21.4%)仅有抑郁症,39例(12.3%)既有焦虑症又有抑郁症。在62.6%的就诊过程中讨论了心理健康问题,不过先前被诊断为焦虑和/或抑郁的患者(P < .001)更有可能接受评估。很少有患者接受治疗(6.9%)或服用精神科药物(8.5%)。抑郁症患者中黑人比例较高,而焦虑症和抑郁症患者中白人比例较高(P < .001)。
讨论
我们强调需要对所有怀孕的青少年/青年进行焦虑和抑郁评估。我们鼓励未来开展研究,调查患者对心理健康支持的偏好,并加强旨在治疗和了解这一独特人群焦虑/抑郁情况的临床项目。