Anxiety, depression, and mental health service use among pregnant adolescents/young adults at an urban pediatric hospital based clinic

Purpose Adolescence 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. Methods We 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 ( N = 318), including demographic characteristics, pregnancy-related factors, mental health diagnoses, and service use. Results Of 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 ( p < .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 ( p < .001). Discussion We 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.