Depressive symptomatology in the immediate postnatal period: identifying maternal characteristics related to true- and false-positive screening scores.

OBJECTIVE: To determine whether true- and false-positive postnatal depression screening scores can be distinguished during the early postpartum period by examining characteristic differences between 2 groups: 1) women with depressive symptomatology at 1 week postpartum who continue to exhibit symptoms at 8 weeks postpartum, compared with those who do not; and 2) women with depressive symptomatology at 8 weeks postpartum who previously exhibited symptoms at 1 week postpartum, compared with those who did not.
METHOD: As part of a longitudinal postpartum depression study, a population-based sample of 594 women completed mailed questionnaires at 1, 4, and 8 weeks postpartum.
RESULTS: Among women with depressive symptomatology at 1 week postpartum, diverse variables distinguished between those whose symptoms persisted or remitted at 8 weeks. These variables included recent immigrant status, psychiatric history, premenstrual symptoms, vulnerable personality, low self-esteem, child abuse history, and insufficient support. Variables that distinguished between women with depressive symptomatology at 8 weeks postpartum who previously exhibited symptoms at 1 week postpartum and those who did not included vulnerable personality, life stressors, perceived stress, insufficient support, and partner conflict.
CONCLUSIONS: To address both the benefits and potential harms of early screening, positive screening scores on the Edinburgh Postnatal Depression Scale should also include an assessment of each individual woman's risk for postpartum depression and (or) chronic major depression.