title: Predicting postnatal depression.
abstract: BACKGROUND
  The contribution that recently identified risk factors for Postnatal Depression (PND) made to an existing prenatal screening tool ('Predictive Index' of PND; Cooper et al., 1996) was assessed in an attempt to improve the performance of this measure.
  
  
  METHODS
  The Predictive Index and measures of appraisal and coping were administered during the final trimester of pregnancy (n=306). The Edinburgh Postnatal Depression Scale (EPDS) and Childcare Stress Inventory were completed at 6-weeks postpartum (n=223).
  
  
  RESULTS
  The predictive index identified 23% of PND cases. The addition of specific appraisal and coping factors increased predictive performance by 26%. Inclusion of maternal reports of childcare stress in the early postpartum period resulted in a further 15% of PND cases being identified.
  
  
  CONCLUSIONS
  Diagnostic criteria were not used to assess the incidence of PND; instead PND case status was assessed using an established cut-off criterion on the EPDS. In addition, the contribution that women's prenatal appraisal and coping processes made to improving the predictive index was not assessed on a second independent sample.
  
  
  CONCLUSIONS
  The inclusion of prenatal appraisal, coping and maternal reports of childcare stress in a screening tool for PND substantially increased predictive performance, resulting in 64% of PND cases being identified. These findings highlight the importance of negative prenatal appraisal and coping processes in the development of PND and have important implications for the prevention and treatment of this disorder.
authors.affiliation: School of Psychology, Cardiff University, PO Box 901, Park Place, Cardiff CF10 3YG, Wales, UK. honeyk@cardiff.ac.uk
authors.forename: Kyla L
authors.initials: KL
authors.lastname: Honey
authors.forename: Paul
authors.initials: P
authors.lastname: Bennett
authors.forename: Michelle
authors.initials: M
authors.lastname: Morgan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008403:Mass Screening; D008609:Mental Status Schedule; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000523:psychology; D011379:Prognosis; D011594:Psychometrics; D012307:Risk Factors; D013315:Stress, Psychological