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

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Howard, Louise Michele, Ryan, Elizabeth G., Trevillion, Kylee, Anderson, Fraser, Bick, Debra, Bye, Amanda, Byford, Sarah, O'Connor, Sheila, Sands, Polly, Demilew, Jill, Milgrom, Jeannette and Pickles, Andrew (2018) Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy. The British Journal of Psychiatry, 212 (1). pp. 50-56. doi:10.1192/bjp.2017.9

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Official URL: http://dx.doi.org/10.1192/bjp.2017.9

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Abstract

Background:
There is limited evidence on the prevalence and identification of antenatal mental disorders.

Aims:
To 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.

Method:
Cross-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.

Results:
Population 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).

Conclusions:
Endorsement 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.

Item Type: Journal Article
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Pregnant women -- Mental health, Mental illness in pregnancy, Depression, Mental -- Diagnosis, Maternal health services
Journal or Publication Title: The British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
ISSN: 0007-1250
Official Date: 4 January 2018
Dates:
DateEvent
4 January 2018Published
17 August 2017Accepted
Volume: 212
Number: 1
Page Range: pp. 50-56
DOI: 10.1192/bjp.2017.9
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RP-PG-1210-12002National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
CLAHRC-2013-10022National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR-RP-R32-011National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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