M-P Austin1, J Lumley. 1. Mood Disorders Unit and School of Psychiatry University of New South Wales, Sydney, Australia. m.austin@unsw.edu.au
Abstract
OBJECTIVE: To describe the screening properties of the antenatal tools which have been developed to predict depression after birth and to summarize the implications of the findings for antenatal screening. METHOD: Systematic review and secondary analysis of published papers. RESULTS: Sixteen studies including sufficient data for the calculation of screening properties were identified. The majority developed a study-specific screening instrument. Outcome assessments used the Edinburgh Postnatal Depression Scale or standardized diagnostic psychiatric interviews, or both. In the two largest population-based studies, the proportion of women screening as positive ('at risk' of postnatal depression) was 16 and 52%, respectively, and of these only 35 and 8% actually developed depression after birth. CONCLUSION: No screening instrument(s) met the criteria for routine application in the antenatal period. Factors that may have affected poor sensitivity and positive predictive values include the exclusion of key domains in predicting risk, particularly personality, a past history of abuse and postnatal events, the contribution of which may be being under-estimated in studies evaluating antenatal risk prediction tools.
OBJECTIVE: To describe the screening properties of the antenatal tools which have been developed to predict depression after birth and to summarize the implications of the findings for antenatal screening. METHOD: Systematic review and secondary analysis of published papers. RESULTS: Sixteen studies including sufficient data for the calculation of screening properties were identified. The majority developed a study-specific screening instrument. Outcome assessments used the Edinburgh Postnatal Depression Scale or standardized diagnostic psychiatric interviews, or both. In the two largest population-based studies, the proportion of women screening as positive ('at risk' of postnatal depression) was 16 and 52%, respectively, and of these only 35 and 8% actually developed depression after birth. CONCLUSION: No screening instrument(s) met the criteria for routine application in the antenatal period. Factors that may have affected poor sensitivity and positive predictive values include the exclusion of key domains in predicting risk, particularly personality, a past history of abuse and postnatal events, the contribution of which may be being under-estimated in studies evaluating antenatal risk prediction tools.
Authors: Alexander C Tsai; Mark Tomlinson; Sarah Dewing; Ingrid M le Roux; Jessica M Harwood; Mickey Chopra; Mary Jane Rotheram-Borus Journal: Arch Womens Ment Health Date: 2014-03-30 Impact factor: 3.633
Authors: Elizabeth A Howell; Susan Bodnar-Deren; Amy Balbierz; Holly Loudon; Pablo A Mora; Caron Zlotnick; Jason Wang; Howard Leventhal Journal: Arch Womens Ment Health Date: 2013-09-10 Impact factor: 3.633
Authors: Kristin J Hung; Mark Tomlinson; Ingrid M le Roux; Sarah Dewing; Mickey Chopra; Alexander C Tsai Journal: Int J Gynaecol Obstet Date: 2014-04-02 Impact factor: 3.561
Authors: Thalia K Robakis; Katherine E Williams; Susan Crowe; Heather Kenna; Jamie Gannon; Natalie L Rasgon Journal: Arch Womens Ment Health Date: 2014-08-05 Impact factor: 3.633