Perinatal Mood And Anxiety Disorders Rose Among Privately Insured People, 2008-20

Abstract

Nationwide, perinatal mood and anxiety disorder (PMAD) diagnoses among privately insured people increased by 93.3 percent from 2008 to 2020, growing faster in 2015-20 than in 2008-14. Most states and demographic subgroups experienced increases, suggesting worsening morbidity in maternal mental health nationwide. PMAD-associated suicidality and psychotherapy rates also increased nationwide from 2008 to 2020. Relative to 2008-14, psychotherapy rates continued to rise in 2015-20, whereas suicidality rates declined.

Exhibit 1

Diagnoses of perinatal mood and anxiety disorder (PMAD) per 10,000 deliveries in the US among privately insured women, 2008–20 SOURCE Authors’ analysis of Optum Clinformatics Data Mart claims data for women ages 15–44 who had a live-birth delivery during the period 2008–20 and had continuous enrollment in a single health plan for 12 months before and 12 months after delivery. NOTE Additional details are in the technical appendix (see note 8 in text).

Exhibit 2

Total diagnoses of perinatal mood and anxiety disorder (PMAD) per 10,000 deliveries in the US among privately insured women, pre–Affordable Care Act (ACA) and post-ACA, by age, race and ethnicity, and geographic region, 2008–20 SOURCE Authors’ analysis of Optum Clinformatics Data Mart claims data for women ages 15–44 who had a live-birth delivery during the period 2008–20 and had continuous enrollment in a single health plan for 12 months before and 12 months after delivery. NOTE Unadjusted PMAD cases per 10,000 live-birth deliveries are presented as the differences between the pre-ACA period (2008–14) and the post-ACA period (2015–20).

Exhibit 3

Total diagnoses of perinatal mood and anxiety disorder (PMAD) per 10,000 deliveries in the US among privately insured women, pre–Affordable Care Act (ACA) and post-ACA, by state, 2008–20 SOURCE Authors’ analysis of Optum Clinformatics Data Mart claims data for women ages 15–44 who had a live-birth delivery during the period 2008–20 and had continuous enrollment in a single health plan for 12 months before and 12 months after delivery. NOTE Unadjusted PMAD cases per 10,000 live-birth deliveries are presented as the differences between the pre-ACA period (2008–14) and the post-ACA period (2015–20).

Exhibit 4

Annual rate of change in the number of diagnosed perinatal mood and anxiety disorders (PMAD) per 10,000 deliveries in the US among privately insured women, 2008–20 SOURCE Authors’ analysis of Optum Clinformatics Data Mart claims data for women ages 15–44 who had a live-birth delivery during the period 2008–20 and had continuous enrollment in a single health plan for 12 months before and 12 months after delivery. NOTES Changes reflect unadjusted year-to-year differences during the period 2008–20. States with fewer than 10 diagnosed PMAD cases per year are suppressed (designated “Data suppressed”). Additional details are in the technical appendix (see note 8 in text).

Exhibit 5

Diagnoses of suicidality among privately insured women diagnosed with perinatal mood and anxiety disorders (PMAD) per 10,000 deliveries in the US, 2008–20 SOURCE Authors’ analysis of Optum Clinformatics Data Mart claims data for women ages 15–44 who had a live-birth delivery during the period 2008–20 and had continuous enrollment in a single health plan for 12 months before and 12 months after delivery. NOTES Unadjusted prevalence of suicidality is presented as two trend lines superimposed to smooth out the year-to-year fluctuation in the data and illustrate the differences between the pre–Affordable Care Act (ACA) period (2008–14) and the post-ACA period (2015–20). Additional details are in the technical appendix (see note 8 in text).

Exhibit 6

Use of psychotherapy among privately insured women diagnosed with perinatal mood and anxiety disorders (PMAD) per 10,000 deliveries in the US, 2008–20 SOURCE Authors’ analysis of Optum Clinformatics Data Mart claims data for women ages 15–44 who had a live-birth delivery during the period 2008–20 and had continuous enrollment in a single health plan for 12 months before and 12 months after delivery. NOTE Additional details are in the technical appendix (see note 8 in text).