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Title: Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy.
Austin Authors: 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 ;Pickles, Andrew
Affiliation: Section of Women's Mental Health,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
South London and Maudsley NHS Foundation Trust, London
Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
Women's Health Academic Centre, King's College London, London
Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London
King's Health Economics,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
Women's Health, King's College Hospital NHS Foundation Trust, London
Parent-Infant Research Institute, Austin Health, Heidelberg, Victoria, Australia
Melbourne School of Psychological Sciences, University of Melbourne, Australia
Issue Date: Jan-2018
Publication information: The British journal of psychiatry 2018; 212(1): 50-56
Abstract: 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. 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. 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). 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. Declaration of interest L.M.H. chaired the National Institute for Health and Care Excellence CG192 guidelines development group on antenatal and postnatal mental health in 2012-2014.
DOI: 10.1192/bjp.2017.9
ORCID: 0000-0002-4082-4595
Journal: The British journal of psychiatry : the journal of mental science
PubMed URL: 29433610
Type: Journal Article
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