RT Journal Article SR Electronic T1 Stepped Care Treatment of Postpartum Depression: Impact on Treatment, Health, and Work Outcomes JF The Journal of the American Board of Family Medicine JO J Am Board Fam Med FD American Board of Family Medicine SP 473 OP 482 DO 10.3122/jabfm.2009.05.080192 VO 22 IS 5 A1 Gjerdingen, Dwenda A1 Crow, Scott A1 McGovern, Patricia A1 Miner, Michael A1 Center, Bruce YR 2009 UL http://www.jabfm.org/content/22/5/473.abstract AB Purpose: The purpose of this study was to pilot a stepped collaborative care intervention for women with postpartum depression and evaluate health differences between self-diagnosed depressed and nondepressed women.Methods: Five hundred six mothers of infants from 7 clinics completed surveys at 0 to 1, 2, 4, 6, and 9 months postpartum and a Structured Clinical Interview for DSM-IV (SCID). SCID-positive depressed women were randomized to stepped collaborative care or usual care. Nine-month treatment, health, and work outcomes were evaluated for stepped care women (n = 19) versus control depressed women (n = 20), and self-diagnosed depressed women (n = 122) versus nondepressed women (n = 344).Results: Forty-five women had SCID-positive depression whereas 122 had self-diagnosed depression. For SCID-positive depressed women, the stepped care intervention increased mothers’ awareness of their depression diagnosis (100% vs 61%; P = .008) and their receipt of treatment (94% vs 56%; P = .019). Self-diagnosed depressed women (vs nondepressed women) had more depressive symptoms and acute care visits, worse general and mental health, and greater impact of health problems on regular activities.Conclusions: The stepped care intervention improved women's knowledge of their postpartum depression diagnosis and their receipt of treatment. However, our formal diagnostic procedures missed many women whose depressed mood interfered with their health and function.