title: Can we identify mothers at-risk for postpartum anxiety in the immediate postpartum period using the State-Trait Anxiety Inventory?
abstract: BACKGROUND
  This study assessed the stability of maternal anxiety and concordance between State-Trait Anxiety Inventory (STAI) scores in the immediate postpartum period to 8 weeks postpartum.
  
  
  METHODS
  A population-based sample of 522 mothers completed the STAI at 1, 4, and 8 weeks postpartum. Sensitivity, specificity, and predictive power of the 1-week STAI in relation to identifying mothers with elevated STAI scores at 4 and 8 weeks was determined. Predictive power of the STAI was further assessed using odds ratios and receiver operator characteristic (ROC) curves.
  
  
  RESULTS
  At 1 week postpartum, 22.6% of mothers scored >40 on the STAI, decreasing to 17.2% at 4 weeks and 14.8% at 8 weeks. Using the cut-off score of >40, the 1-week STAI accurately classified 84.0% mothers at 4 weeks and 83.6% at 8 weeks with or without anxiety symptomatology. The 1-week STAI was significantly correlated to the 4-week (r=0.68, p<0.001) and 8-week (r=0.64, p<0.001) STAI. Mothers with a 1-week STAI score >40 were 15.2 times more likely at 4 weeks (95% CI=8.9-26.1) and 14.0 times more likely at 8 weeks (95% CI=7.9-24.8) to exhibit postpartum anxiety symptomatology.
  
  
  CONCLUSIONS
  Psychiatric interviews were not completed in collaboration with the STAI and specific types of anxiety disorders were not identified.
  
  
  CONCLUSIONS
  A cut-off score of >40 on the STAI administered early in the postpartum period is recommended in a 2-phase identification program in order to not miss mothers with postpartum anxiety.
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. cindylee.dennis@utoronto.ca
authors.forename: Cindy-Lee
authors.initials: CL
authors.lastname: Dennis
authors.forename: Michelle
authors.initials: M
authors.lastname: Coghlan
authors.forename: Simone
authors.initials: S
authors.lastname: Vigod
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology*; D010555:Personality Inventory; D049590:Postpartum Period / Q000523:psychology*; D015995:Prevalence; D012372:ROC Curve; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Postpartum anxiety; Predictive validity; Screening; Sensitivity and specificity; State-Trait Anxiety Inventory