title: The mental health characteristics of pregnant women with depressive symptoms identified by the Edinburgh Postnatal Depression Scale.
abstract: OBJECTIVE
  Few studies are available on the effectiveness of screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or the extent to which such tools may identify women with mental disorders other than depression. We therefore aimed to investigate the mental health characteristics of pregnant women who screen positive on the EPDS.
  
  
  METHODS
  Consecutive women receiving antenatal care in primary care clinics (from November 2006 to July 2011) were invited to complete the EPDS in week 16 of pregnancy. All women who scored above 11 (screen positive) on the EPDS and randomly selected women who scored below 12 (screen negative) were invited to participate in a psychiatric diagnostic interview.
  
  
  RESULTS
  2,411 women completed the EPDS. Two hundred thirty-three women (9.7%) were screened positive in week 16, of whom 153 (66%) agreed to a psychiatric diagnostic interview. Forty-eight women (31.4%) were diagnosed with major depressive disorder according to DSM-IV criteria, 20 (13.1%) with bipolar disorder, 93 (60.8%) with anxiety disorders (including 27 [17.6%] with obsessive-compulsive disorder [OCD]), 8 (5.2%) with dysthymia, 18 (11.8%) with somatoform disorder, 3 (2%) with an eating disorder, and 7 (4.6%) with current substance abuse. Women who screened positive were significantly more likely to have psychosocial risk factors, including being unemployed (χ(2)(1) = 23.37, P ≤.001), lower educational status (χ(2)(1)= 31.68, P ≤ .001), and a history of partner violence (χ(2)(1) = 10.30, P ≤ 001), compared with the women who screened negative.
  
  
  CONCLUSIONS
  Use of the EPDS early in the second trimester of pregnancy identifies a substantial number of women with potentially serious mental disorders other than depression, including bipolar disorder, OCD, and eating disorders. A comprehensive clinical assessment is therefore necessary following use of the EPDS during pregnancy to ensure that women who screen positive receive appropriate mental health management.
authors.affiliation: Mental Health Services, Landspitali-The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland indabl@landspitali.is.
authors.forename: Linda B
authors.initials: LB
authors.lastname: Lydsdottir
authors.forename: Louise M
authors.initials: LM
authors.lastname: Howard
authors.forename: Halldora
authors.initials: H
authors.lastname: Olafsdottir
authors.forename: Marga
authors.initials: M
authors.lastname: Thome
authors.forename: Petur
authors.initials: P
authors.lastname: Tyrfingsson
authors.forename: Jon F
authors.initials: JF
authors.lastname: Sigurdsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents