A cross-sectional study comparing the Whooley questions and Edinburgh postnatal depression scale against a diagnostic assessment in identifying depression in pregnancy
Antenatal mental disorders are often unrecognized, despite frequent contact with healthcare professionals throughout pregnancy. The UK National Institute for Clinical Excellence recommends maternity professionals use the two Whooley questions to identify depressive disorders – the most common antenatal mental disorder - in the perinatal period. However, it is not clear whether these questions are the optimal method to do this. The Edinburgh Postnatal Depression Scale (EPDS) is an alternative measure which has been used extensively in primary care for detection of depression in the perinatal period.
A cross-sectional study was implemented with a two-phase sampling design drawing a random sample stratified according to being positive or negative on the Whooley questions with nested cohort study for those who agree to continuing participation in the follow up study. The study setting was an inner city maternity service (6000 births/year) at King’s College Hospital, London, with an ethnically and socially diverse population. This study aims to investigate the sensitivity, specificity and positive predictive value of the two Whooley questions compared with the EPDS, and a gold standard diagnostic interview (The Structured Clinical Interview DSM-IV), for the identification of depression at antenatal booking. We will also examine the effect of incorporating covariates into the receiver operating characteristic (ROC) curves for the EPDS to determine whether its discriminatory accuracy varies by different sociodemographic groups.