Temporal trends of co-diagnosis of depression and/or anxiety among female maternal and non-maternal hospitalizations: Results from Nationwide Inpatient Sample 2004–2013

• Published in: Psychiatry research 2019-02, Vol.272, p.42-50
• Main Authors: Pino, Elizabeth C, Zuo, Yi, Schor, Shayna H, Zatwarnicki, Stephanie, Henderson, David C, Borba, Christina PC, Milanovic, Snezana M, Kalesan, Bindu
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anxiety - epidemiology; Anxiety Disorders - epidemiology; Comorbidity - trends; Depression - epidemiology; Depressive Disorder - epidemiology; Female; Hospitalization - statistics & numerical data; Humans; Maternal Health Services - statistics & numerical data; Middle Aged; Perinatal; Postpartum; Pregnancy; Pregnancy Complications - epidemiology; United States - epidemiology; Young Adult
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.12.077

•Rates of female diagnoses of depression/anxiety demonstrated a temporal increase from 2004–2013.•This temporal increase was driven by non-maternal hospitalizations.•Prevalence of diagnosis of depression/anxiety was 8-times greater in non-maternal compared to maternal.•Whites were twice as likely as minorities to have a co-diagnosis of depression and/or anxiety.•These results suggest an underdiagnosis of depression/anxiety among pregnant women. Perinatal depression/anxiety is considered the most underdiagnosed pregnancy complication in the US and is associated with poor maternal and fetal outcomes. However, despite its prevalence, most women who present with depressive symptoms are not screened and do not receive adequate treatment. We examined the clinical co-diagnosis of depression and/or anxiety among maternal and non-maternal hospitalizations among females aged 14–49 from the Nationwide Inpatient Sample (NIS) between 2004 and 2013 (n = 83,472,775). Meta-regression was used to determine annual change and presence of temporal trends. Survey logistic regression was used to examine the association with sociodemographic factors. Rates of diagnosis of depression and/or anxiety disorders demonstrated a temporal increase from 2004–2013, and this increase was mainly driven by non-maternal hospitalizations compared to maternal. Furthermore, non-maternal hospitalizations demonstrated a greater prevalence of depression and/or anxiety diagnoses compared to maternal hospitalizations over the same time period (21•7% versus 2•8%). Among all female hospitalizations, whites were roughly twice as likely as minorities to have a diagnosis of depression and/or anxiety. These results add to the evidence suggestive of the underdiagnosed depression/anxiety present among women of reproductive age, particularly pregnant women and minorities, and underscore the critical role of obstetricians in treating both physical and mental health.