title: What is the best tool for screening antenatal depression?
abstract: BACKGROUND
  Antenatal depression (AD) can have devastating consequences. No existing scales are specifically designed to measure it. Common practice is to adapt scales originally developed for other circumstances. We designed this study to validate and determine the psychometric values for AD screening in Brazil.
  
  
  METHODS
  We collected clinical and socio-demographic data in the second gestational trimester. The following instruments were also administered during that period: MINI-PLUS, EPDS, BDI and HAM-D.
  
  
  RESULTS
  At the time of assessment, 17.34% of the patients were depressed, and 31.98% met the diagnostic criteria for lifetime major depression. All instruments showed an area under the curve in a receiver operating characteristic analysis greater than 0.85, with the BDI achieving a 0.90 and being the best-performing screening instrument. A score ≥11 on the EPDS (81.58% sensitivity, 73.33% specificity), ≥15 on the BDI (82.00% sensitivity, 84.26% specificity) and ≥9 on the HAM-D (87.76% sensitivity, 74.60% specificity) revealed great dichotomy between depressed and non-depressed patients. Spearman׳s rank correlation coefficients (ρ) among the scales had good values (EPDS vs. BDI 0.79; BDI vs. HAM-D 0.70, and EPDS vs. HAM-D 0.67).
  
  
  CONCLUSIONS
  This study was transversal, assessing only women in the second gestational trimester. Results may be applicable only to the Brazilian population since psychometric properties may vary with the population under study. Major depression can amplify somatic symptomatology, affecting depressive rating scale data.
  
  
  CONCLUSIONS
  AD is highly prevalent in Brazil. To address the problem of under-recognition, physicians can use the EPDS, BDI and HAM-D to identify AD.
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Electronic address: tiagocastrocouto@gmail.com.
authors.forename: Tiago
authors.initials: T
authors.lastname: Castro E Couto
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Mayra Yara
authors.initials: MY
authors.lastname: Martins Brancaglion
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Mauro
authors.initials: M
authors.lastname: Nogueira Cardoso
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Andressa
authors.initials: A
authors.lastname: Bergo Protzner
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; National Institute of Science and Technology-Molecular Medicine (INCT-MM), School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Frederico
authors.initials: F
authors.lastname: Duarte Garcia
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; National Institute of Science and Technology-Molecular Medicine (INCT-MM), School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Nicolato
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Regina Amélia
authors.initials: RA
authors.lastname: Lopes P Aguiar
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Henrique
authors.initials: H
authors.lastname: Vitor Leite
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; National Institute of Science and Technology-Molecular Medicine (INCT-MM), School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Humberto
authors.initials: H
authors.lastname: Corrêa
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000523:psychology*; D011296:Prenatal Diagnosis / Q000295:instrumentation*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000592:standards; D011594:Psychometrics; D012372:ROC Curve; D055815:Young Adult
keywords: Antenatal depression; BDI; EPDS; HAM-D; Validation studies