Document Detail


Efficiency of a two-item pre-screen to reduce the burden of depression screening in pregnancy and postpartum: an IMPLICIT network study.
MedLine Citation:
PMID:  18612058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Systems for efficient case finding of women with major depression during pregnancy and postpartum are needed. Here we assess the diagnostic accuracy of a modified 2-item patient health questionnaire (PHQ-2) as a pre-screen in assessing depression.
METHODS: Cross-sectional assessments at 15 weeks' gestation (n = 414), 30 weeks' gestation (n = 334), and 6 to 16 weeks postpartum (n = 193) among women from a diverse set of races/ethnicities, participating in the IMPLICIT maternal care quality improvement network. The Edinburgh Postnatal Depression Scale score (>or=13) was used as the criterion measure for the PHQ-2.
RESULTS: A positive 2-item screen had sensitivity of 93%, 82%, and 80% and specificity of 75%, 80%, and 86% for Edinburgh Postnatal Depression Scale score of >or=13 for assessment at 15 and 30 weeks gestational age and postpartum, respectively. The positive/negative predictive values for the PHQ-2 were 44/98, 24/91, and 30/98 for each time point, respectively. Areas under the receiver operating characteristic curve analysis suggested that 2-item assessments at each time point had approximately equal diagnostic validity.
CONCLUSIONS: Two questions were efficient to rule out depression and reduced the need for further screening of approximately 60% to 80% of women, depending on the point in pregnancy or postpartum. A diagnostic interview follow-up of women screening positive is still required.
Authors:
Ian M Bennett; Andrew Coco; James C Coyne; Alex J Mitchell; James Nicholson; Ellen Johnson; Michael Horst; Stephen Ratcliffe
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Board of Family Medicine : JABFM     Volume:  21     ISSN:  1557-2625     ISO Abbreviation:  J Am Board Fam Med     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-07-09     Completed Date:  2008-11-18     Revised Date:  2014-09-21    
Medline Journal Info:
Nlm Unique ID:  101256526     Medline TA:  J Am Board Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-25     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Sectional Studies
Depression / epidemiology,  prevention & control*
Depression, Postpartum / epidemiology,  prevention & control*
Female
Follow-Up Studies
Humans
Mass Screening / methods*
Pregnancy
Pregnancy Complications / epidemiology,  prevention & control*
Prevalence
ROC Curve
Retrospective Studies
Grant Support
ID/Acronym/Agency:
1K23HD048915-01A2/HD/NICHD NIH HHS; 1R03MH074750-01/MH/NIMH NIH HHS; R03 MH074750/MH/NIMH NIH HHS; R03 MH074750-02/MH/NIMH NIH HHS
Comments/Corrections

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