title: Depression and anxiety in Singaporean high-risk pregnancies - prevalence and screening.
abstract: OBJECTIVE
  Data on psychiatric morbidity in high-risk pregnant Singaporean women are limited. This study aimed to establish the prevalence of antenatal depression and anxiety in high-risk pregnancies, compare the prevalence of antenatal depression in high-risk pregnancies vs. pregnancies of unspecified obstetric risk and examine the Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Inventory (STAI) as screening tools for these disorders.
  
  
  METHODS
  Two hundred high-risk pregnant inpatients at a national public maternity hospital were included. Three psychometric assessment tools were used to evaluate all participants: the diagnostic Mini International Neuropsychiatric Interview and the screening EPDS and STAI.
  
  
  RESULTS
  Rates of major depression, minor depression, anxiety disorder (agoraphobia, generalized anxiety disorder, panic disorder), and comorbid depression and anxiety were 11%, 7%, 12.5% and 5%, respectively. Major depression was more prevalent in high-risk pregnancies than in the historical cohort of unspecified obstetric risk (11% versus 4.3%). EPDS (cutoff 8/9) screens well for depression and anxiety in high-risk pregnancies (area under the receiver operating characteristic curve=0.82-0.87).
  
  
  CONCLUSIONS
  Antenatal depression and anxiety are highly prevalent in a sample of high-risk pregnant Singaporean women. EPDS performs well in screening for depression and anxiety in high-risk pregnant women, with further psychiatric assessment recommended for women with score ≥ 9.
authors.affiliation: Duke-NUS Graduate Medical School, Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857, Singapore. pavaani@nus.edu.sg
authors.forename: Pavaani
authors.initials: P
authors.lastname: Thiagayson
authors.forename: Gita
authors.initials: G
authors.lastname: Krishnaswamy
authors.forename: May Li
authors.initials: ML
authors.lastname: Lim
authors.forename: Sharon Cohan
authors.initials: SC
authors.lastname: Sung
authors.forename: Charlotte Louise
authors.initials: CL
authors.lastname: Haley
authors.forename: Daniel Shuen Sheng
authors.initials: DS
authors.lastname: Fung
authors.forename: John Carson
authors.initials: JC
authors.lastname: Allen
authors.forename: Helen
authors.initials: H
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D016001:Confidence Intervals; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008403:Mass Screening; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D018566:Pregnancy, High-Risk / Q000523:psychology*; D015995:Prevalence; D011446:Prospective Studies; D011594:Psychometrics; D018570:Risk Assessment; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult