Chapter 19 - Screening for antenatal depression (AND) using self-report questionnaires: Conceptual issues and measurement limitations

Abstract

Screening for antenatal depression (AND) is clinically important, with any form of depression impacting upon women’s relationships with her partner and infant postpartum. Surprisingly, screening for AND has received relatively little attention, compared with screening for postnatal depression (PND). Nonetheless, research-informed observations indicate that the impact of AND can be as significant as PND. Screening for AND can be readily undertaken using short self-report questionnaires, which have known validity characteristics and harmonized threshold cut-off scores. Contemporary practice in the UK involves an initial short two-question screening (Whooley Questions), which if post-completion indicates depression may be present, a further short 10-item depression inventory is issued (e.g., EPDS or PHQ-9). Although this system is highly effective for initial recognition of possible depression, a number of conceptual and pragmatic issues are important when applying these measures in everyday clinical practice.