The natural history and NHS service use of women with depression, and impact on children in a multi-ethnic inner-city population

We aim to describe the natural history of depression and its consequences for women pre- and post-pregnancy in a multi-ethnic and economically deprived community in Bradford.

e plan to build an enhanced dataset composed of a suite of baseline measures taken at ~28 weeks gestation from the 13,000 women enrolled in the Born in Bradford Cohort; uniquely linked to the local GP database, SystmOne. To extract the NHS data we will devise and test an algorithm of previously validated Read codes for depression diagnoses, screening, symptoms, and treatment referrals along with anti-depressant prescribing and counts of consultations for any reason. We will devise a similar algorithm for anxiety. NHS data will be drawn 15 months prior to the index birth and for 3 years post-natally. We will use further measures of mental health (GHQ-28 and Kessler Scale for Psychological Distress) and parenting practices up to 3 years post-partum for the subsample of BiB1000 women along with child behavioural outcomes (SDQ) at 3 years.

Research questions

  1. What proportion of women with depression are not treated within the NHS in the year before and 3 years after the birth of a child?
  2. What is the variation between NHS and BiB cohort mental health data?
  3. What ethnicity and other socio-demographic features denote women who do not present to the NHS for treatment of depression, compared to those who are treated and those who are not depressed?
  4. Is there any variation in emotional and behavioural outcomes (SDQ) at age 3 for children of women who are and are not treated for depression, and those who are not depressed?

The results will describe social inequality in service use and quantify impacts of health seeking behaviour on children. Findings will be disseminated through academic routes, exploitation of local public involvement and engagement with NHS and other agencies via dissemination specialists.