In this issue, the article by Ko et al. has a number of important findings. The authors used a large dataset (National Surveys on Drug Use and Health) of 77,415 women between the ages of 18 and 44 in order to determine the past-year prevalence of depression, diagnosis and treatment of depression, and barriers to seeking care in both pregnant and nonpregnant women. Using the DSM-IV definition of a major depressive episode (MDE), the authors determined that 10.9% of the women reported symptoms consistent with an MDE in the past year. Strikingly, 58.8% of those who met criteria for an. MDE never received a diagnosis of depression, and pregnant women had a higher prevalence of undiagnosed depression (65.9%) compared to nonpregnant women (58.6%), although this was not statistically significant. Women with undiagnosed depression were more likely to be from a racial or ethnic minority. The most common barriers to care were cost, stigma, and opposition to treatment, which likely also reflect the stigma associated with psychiatric illness.
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