{"doi":"10.1111/acps.13644","title":"Trends in psychotherapy utilization for perinatal mental health 2008–2020","abstract":"Psychotherapy is an evidence-based non-pharmacological treatment and is an effective and appropriate treatment for perinatal mental health disorders.1 Psychotherapy initiated in pregnancy can have numerous positive effects, such as reducing risks for postpartum depression, improving relationship quality, preventing anxiety and treating depression through remission.2 Despite these facts, the overall trends in psychotherapy utilization during the perinatal period (pregnancy and postpartum) among privately insured adults in the United States remain unknown. In this study, we examined the trends in psychotherapy utilization during the prenatal or postpartum period among individuals aged 15–44 using Optum's de-identifed Clinformatics® Data Mart Database (CDM). CDM is a statistically deidentified claims data warehouse of administrative medical claims for a national, commercially insured population across 50 US states with data available through the year 2020. All individuals could have had access to psychotherapy. We identified individuals with deliveries from 2008 to 2020 and restricted the sample to those with continuous enrollment in a single employer-based health plan for at least 1 year before and 1 year after a live birth. We required individuals in the study cohort to have continuous enrollment for this 2-year period to measure treatment access throughout pregnancy and postpartum. We identified individuals with delivery hospitalizations using standardized International Classification of Disease-9th and 10th Revision-Clinical Modification (ICD-9-CM and ICD-10-CM) diagnosis and procedure codes. We identified individuals who utilized psychotherapy during the prenatal and postpartum period using standardized Current Procedural Terminology (CPT) codes. We summarized demographic characteristics for all individuals and for those who utilized psychotherapy during the prenatal or postpartum period. We presented sample size and proportions with associated 95% confidence intervals for all the demographic characteristics. We applied generalized estimating equations (GEE) regression to assess the probability of psychotherapy utilization overtime adjusting for race, age, and Bateman score. To describe psychotherapy utilization rates across racial category groups, we then calculated the predicted probabilities of psychotherapy utilization rates for each year of the study period by racial category. We multiplied predicted probabilities by 10,000 to display rates of psychotherapy utilization per 10,000 deliveries. We performed all claims data management in SAS version 9.4 (SAS Institute) and statistical analyses in R (R Core Team). We present main results as a figure and additional results as an Table A1. During the study period between 2008 and 2020, of the 736,325 commercially insured perinatal individuals, 112,022 (15.21%) utilized psychotherapy in either the prenatal or postpartum period. Psychotherapy rates showed a significant increase of 250%, from 1091 (95% CI: 1067–1115) per 10,000 individuals in 2008 to 2726 (95% CI: 2687–2764) per 10,000 individuals in 2020 (Figure 1A). Rates of perinatal psychotherapy utilization exhibited similar growth across all racial groups during the study period. White individuals recorded the highest rates, followed by Black, Hispanic, and Asian groups, respectively. The most significant increase in crude psychotherapy rates was observed among Asian individuals, with a 490% surge from 423 (95% CI: 363–484) per 10,000 individuals in 2008 to 2073 (95% CI: 1936 – 2209) per 10,000 individuals in 2020 (Figure 1). In contrast, psychotherapy rates among White individuals demonstrated the least growth compared to other racial groups, with a 232% increase from 1255 (95% CI: 1222–1288) per 10,000 in 2008 to 2909 (95% CI: 2859–2959) per 10,000 in 2020 (Figure 1A). After adjusting for age and Bateman comorbidity score, the general trend remained unchanged. However, the rate of increase in psychotherapy among Asian ind","journal":"Acta Psychiatrica Scandinavica","year":2023,"id":385715,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9493,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":557901,"name":"Dana Beck","orcid":"0000-0001-5405-2744","position":1,"is_corresponding":false},{"id":268984,"name":"Xiaosong Zhang","orcid":null,"position":2,"is_corresponding":false},{"id":1133520,"name":"Stephanie V. Hall","orcid":"0000-0002-8748-4735","position":3,"is_corresponding":false},{"id":1093383,"name":"Anca Tilea","orcid":"0000-0002-0252-4305","position":4,"is_corresponding":false},{"id":1093790,"name":"Gloria Sugg","orcid":null,"position":5,"is_corresponding":false},{"id":1093385,"name":"Amy Schroeder","orcid":"0009-0001-2019-1970","position":6,"is_corresponding":false},{"id":261091,"name":"Vanessa K. Dalton","orcid":null,"position":7,"is_corresponding":false},{"id":265843,"name":"Kara Zivin","orcid":"0000-0001-8246-6864","position":8,"is_corresponding":false},{"id":23289,"name":"Karen M. Tabb","orcid":"0000-0002-4722-9502","position":0,"is_corresponding":true}],"reference_count":5,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:17:52.636565Z","pmid":"38056448","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}