(1177) Collaborative care model reduces perinatal mood and anxiety symptoms

Objective: Collaborative care (CC) models, which embed mental health care into the outpatient setting, have been shown to improve mental health outcomes in primary care settings, but evidence is still scarce for effectiveness in perinatal settings. We aimed to determine if our CC intervention model would decrease depressive and anxiety symptoms in our perinatal population.

Study Design: Patients from three prenatal clinics at Weill Cornell Medicine were systematically screened and those with an Edinburgh Postnatal Depression Scale (EPDS) ≥9 were eligible for referral. EPDS, Perinatal Anxiety Screening Scale (PASS), Generalized Anxiety Disorder Screen (GAD-7), Adverse Childhood Experiences Questionnaire (ACE) and Client Satisfaction Questionnaire (CSQ-8) were measured at the intake and discharge visits. Treatment plans included psychotherapy, medication management, or referral to psychiatry for long-term management. Differences in depression and anxiety scales were compared between the intake and discharge visits.

Results: During 1/23/23-07/24/24, 219 patients completed the CC program. Demographics and patient treatment plans are shown in Table 1. 158 (72.5%) of enrolled patients had a past mental health history. Most patients had current anxiety or obsessive-compulsive disorder, adjustment disorder, or a depressive disorder at the intake visit. 42 (19.4%) patients were taking psychiatric medications at the intake visit and 33 of those patients (78.6%) were on an SSRI. 72 (33%) were on a medication at time of discharge, with 83.3% being an SSRI. There were significant changes in EPDS, PASS and GAD-7 scores from intake to discharge visit (p< 0.001) (Table 2). Patients showed high scores on the CSQ-8, indicating high satisfaction with the CC.

Conclusion: A CC program within the OB setting is an effective intervention to reduce perinatal symptoms of anxiety and depression.