Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy

Abstract

BackgroundThere is limited evidence on the prevalence and identification of antenatal mental disorders.AimsTo investigate the prevalence of mental disorders in early pregnancy and the diagnostic accuracy of depression-screening (Whooley) questions compared with the Edinburgh Postnatal Depression Scale (EPDS), against the Structured Clinical Interview DSM-IV-TR.MethodCross-sectional survey of women responding to Whooley questions asked at their first antenatal appointment. Women responding positively and a random sample of women responding negatively were invited to participate.ResultsPopulation prevalence was 27% (95% CI 22–32): 11% (95% CI 8–14) depression; 15% (95% CI 11–19) anxiety disorders; 2% (95% CI 1–4) obsessive–compulsive disorder; 0.8% (95% CI 0–1) post-traumatic stress disorder; 2% (95% CI 0.4–3) eating disorders; 0.3% (95% CI 0.1–1) bipolar disorder I, 0.3% (95% CI 0.1–1%) bipolar disorder II; 0.7% (95% CI 0–1) borderline personality disorder. For identification of depression, likelihood ratios were 8.2 (Whooley) and 9.8 (EPDS). Diagnostic accuracy was similar in identifying any disorder (likelihood ratios 5.8 and 6).ConclusionsEndorsement of Whooley questions in pregnancy indicates the need for a clinical assessment of diagnosis and could be implemented when maternity professionals have been appropriately trained on how to ask the questions sensitively, in settings where a clear referral and care pathway is available.Declaration of interestL.M.H. chaired the National Institute for Health and Care Excellence CG192 guidelines development group on antenatal and postnatal mental health in 2012–2014.

Is there an increased risk of perinatal mental disorder in women with gestational diabetes? A systematic review and meta‐analysis

“…We found that the prevalence of high levels of depressive symptoms around the time of GDM diagnosis was 28% (pooled OR 2.08) and following diagnosis was 26% (pooled OR 1.41). This is higher than that expected in the general pregnant population [26,27]. In the postpartum, the prevalence of depression in women diagnosed with GDM during pregnancy was 13% (pooled OR 1.59).…”

“…Of the 17 studies not included in meta-analysis (Tables S2 and S3), there were 11 for which the time of depression measurement in the antepartum in relation to GDM diagnosis could not be ascertained (references 18,20,23,27,30,35,40,46,49,51 and 60 in Appendix S2). One study provided only results stratified by BMI (reference 59 in Appendix S2) and another used depression as exposure not outcome (reference 53 in Appendix S2).…”

Psychometric properties of the five-level EuroQoL-5 dimension and Short Form-6 dimension measures of health-related quality of life in a population of pregnant women with depression

“…The purpose of the WENDY study was to determine the prevalence of antenatal common mental disorders and to investigate the effectiveness and cost-effectiveness of the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) in identifying antenatal depression. 6 …”

Public health nurses’ perinatal mental health training needs: A cross sectional survey

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