Edinburgh Depression Scale Scores Research Articles

Association between iron-deficiency anemia and antenatal depression in a semi-urban population of south India: A cross-sectional study

Introduction: Iron-deficiency anemia (IDA) during pregnancy affects the glial cells of the brain of mother, which results in altered neuronal myelination with dysregulation. Although several factors could lead to antenatal depression, IDA is an emerging etiology. The primary objective of this study is to determine the relationship between IDA and antenatal depression among pregnant women.Materials and Methods: This cross-sectional study was conducted at Government Head Quarters and Hospital, in Udhagamandalam. A total of 210 pregnant women in the second trimester were enrolled and categorized into iron-deficient anemia and noniron-deficient anemia groups based on their hematological results. The risk of depression was assessed using the validated Edinburgh Depression Scale (EDS). A Chi-square test for categorical variables and an independent t-test for continuous variables were used. A Pearson's correlation analysis was performed to check the association of EDS scores with participants' demographic characteristics and hematological parameters. Regression analysis was conducted to predict the outcome variable.Results: The distribution of depression was significantly varied between the groups. EDS score was significantly higher in the IDA group in comparison with the non-IDA group (12.78 ± 3.40 vs. 8.82 ± 3.12; P = 0.005; 95% confidence interval 2.94–4.87). The odds of developing antenatal depression are 12 times higher in the iron-deficient group, P < 0.001.Conclusions: Our findings suggest that IDA acts as an independent factor in influencing antenatal depression.The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement.

There's no sugar-coating psychological distress and illness perceptions in gestational diabetes mellitus: depression and anxiety are associated with negative illness perceptions.

To gain an understanding of how women with gestational diabetes perceive their illness, and whether depressive/anxiety symptoms and/or psychological distress influence these illness perceptions. A cross-sectional study was conducted with 159 pregnant women aged 18-44 attending gestational diabetes clinics. Participants completed a questionnaire, which included the Edinburgh Depression Scale (EDS), Kessler 10-item Psychological Distress Scale (K-10), Brief Illness Perception Questionnaire (BIPQ), and psychiatric/general health items. Multiple regression was used to explore the relationship between EDS (total and anxiety subscale) scores and BIPQ scores, as well as between K-10 (total and anxiety subscale) scores and BIPQ scores. Regression analysis revealed a positive association between EDS total/anxiety subscale scores and BIPQ total score, as well as between K-10 total/anxiety subscale scores and BIPQ total score, controlling for potentially confounding variables. There was a strong positive correlation between EDS total score and K-10 total score. The most frequently expressed concern about GDM was an adverse effect on their baby's health. A poor diet was the most frequently reported perceived 'cause' of GDM. Greater severity of depressive and anxiety symptoms, and psychological distress, is associated with more negative illness perceptions of GDM in pregnant women.

Changes in depression symptoms in Mexican women during the COVID-19 pandemic

BACKGROUND AND AIM: While COVID-19 infection affects health directly, the pandemic response has widespread implications as physical and social environments were radically changed by social distancing and stay at home measures. Mental health effects are important effects to track. We aimed to examine changes in depression and stress levels before and during the COVID-19 pandemic in women from a longitudinal cohort based in Mexico City. METHODS: We studied 471 women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study, who completed the Edinburgh Depression Scale (EDS) prior to the pandemic (2018-2019) and during the pandemic (May-November 2020). Change in EDS score between the two time periods was calculated. New onset depression was defined an EDS score 12 only in the pandemic period. Psychosocial stress for both time periods was ascertained through endorsement of negative life events across 11 domains using the CRISYS questionnaire. Associations between stress at both time periods and depression were analyzed in generalized linear models adjusting for age, socio-economic status and family social support. RESULTS:Higher stress (median) during the pandemic, but not prior to it, was associated with an increase in depression score (β: 2.22; 95%CI [1.15, 3.28]), and higher odds of new onset depression (OR: 1.25; 95% CI [1.01, 1.55]). Higher stress during the pandemic in particular domains, including personal relationships (β: 1.82 [95%CI: 0. 84, 2.80], home (β:1.41; [95%CI 0.22, 2.60]) and financial (β: 1.72; [95%CI: 0.71, 2.73]) were associated with an increase in depression score. We did not find significant differences in the distribution of depression or stress scores pre and during pandemic. CONCLUSIONS:High levels of stress during the pandemic were associated with increases in depression scores and new onset depression. Future studies should examine the long-term effects of stress associated with the pandemic on mental and overall health. KEYWORDS: mental health outcomes, female, covid-19, epidemiology

Changes in Depressive Symptoms, Stress and Social Support in Mexican Women during the COVID-19 Pandemic.

The aim of this study was to examine changes in depression, stress and social support levels before and during the COVID-19 pandemic in women living in Mexico City. We studied 466 women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study who completed the Edinburgh Depression Scale (EDS) questionnaire prior (2018–2019) and during the lockdown period of the pandemic (May–November 2020). Psychosocial stress and social support for both time periods were ascertained using the Crisis in Family Systems (CRISYS) questionnaire and the Social Support Network (SSN) Scale, respectively. Associations between stress, social support and change in EDS score/depression were analyzed using generalized linear models adjusting for covariates. Higher stress (>median) during the pandemic was associated with an increase in EDS score (β: 2.13; 95% CI (1.06, 3.19), p < 0.001), and higher odds of depression (OR: 3.75; 95% CI (2.17, 6.50), p < 0.001), while social support was associated with lower odds of depression (OR: 0.56, 95% CI (0.32, 0.97), p = 0.037). Higher levels of stress during the pandemic were associated with depression. Social support may act as a buffer for the effects of psychosocial stress. Future studies should examine the long-term effects of stress associated with the pandemic on mental and overall health.

701: The effects of antepartum depressive symptoms on post-cesarean opioid consumption

To test the hypothesis that antepartum depressive symptoms are associated with increased pain scores and opioid use during postpartum hospitalization. Retrospective cohort of English or Spanish-speaking women > 18 years who had prenatal care for a singleton gestation and delivered by cesarean (CS) at > 36 weeks within a tertiary center during 2017 where all women are screened for depression with an antenatal Edinburgh Depression Scale (EDS). Exclusions included fetal anomalies or death, sickle cell disease, substance misuse, chronic pain, and fibromyalgia. Women with no EDS scores recorded antenatally were excluded. Major depressive symptoms (MDS) were defined as a documented antenatal EDS >=12 and no MDS if EDS< 12. MDS groups were compared with Student’s t-test, Wilcoxon rank sum tests, Chi-square, and exact tests where appropriate. Multiple linear regression modeled pain by MDS status controlling for smoking and anesthesia; model for opioid use included pain as well. Of the 891 patients reviewed, 676 (76%) had documented antenatal EDS scores, and 104 (15.4%) had MDS. Women with MDS were more likely to be single, use tobacco, and have general anesthesia for CS, but were otherwise similar (Table 1). Women with MDS reported higher daily and average pain scores (Table 2). In bivariate analyses, women with MDS used more morphine milligram equivalents (MME) each day during their postpartum hospitalization, leading to a higher total MME use (121mg (60.5-214.5) vs 75mg (28.5-133.5), p< 0.001). However, when adjusted for pain, MME use was not statistically significant (p=0.15). Our study supports an association between antepartum MDS and acute pain after CS leading to increased opioid use. Given the current focus on opioid stewardship, further research into this association, exploration of tailored pain control, and determining whether treatment of antepartum MDS reduces postpartum pain, and therefore opioid use, will be of the utmost priority.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Increase of depressive symptomatology during pregnancy over 25 years’ time in four population based cohorts

BackgroundThe use of psychotropic drugs for depression during pregnancy has increased over the past decades, but it is unclear whether women are becoming more depressed over time. MethodsWe investigated the occurrence of depressive symptoms during pregnancy in four cohorts (N 300–2000) in the same area in the Netherlands over a period of 25 years using a similar study design. Depressive symptoms were assessed using the Edinburgh Depression Scale (EDS) at various time points during pregnancy. Demographics, lifestyle factors, obstetric characteristics and EDS scores were compared between the four cohorts. ResultsFrom 1988 to 2014, Mean EDS scores during the first and third trimester of pregnancy increased significantly (P < 0.001). The number of women with elevated EDS scores doubled from 7% in 1988–1989 to 14% in 2012–2014 (P = 0.001). The number of highly educated women increased from 23% to 66% and those with paid employment from 75% to 95%, while smoking and alcohol use decreased significantly (all Ps < 0.001). These trends were similar to those of the National Statistics. A previous history of depression, multi-parity and paid employment were associated with higher EDS scores. LimitationsWomen were highly educated, predominantly Caucasian and had a partner. ConclusionsParadoxically, there was a significant increase in depressive symptomatology during pregnancy over a period of 25 years, while protective factors for depression during pregnancy improved. Potential explanations could be greater awareness, high societal expectations, use of social media or the stressful combination of paid work and children at home.

Depressive symptoms and comorbid problems in pregnancy - results from a population based study

ObjectiveTo estimate the prevalence of antenatal depressive symptoms, identify relevant risk factors, and assess comorbid mental health problems, among pregnant women enrolled in a population based study. MethodsThis was a secondary analysis of data collected from 1916 pregnant women who participated in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) study in Kuwait, and had answered the Baseline Questionnaire and completed the Edinburgh Depression Scale (EDS). Logistic regression models were used to examine the association of depressive symptoms with baseline socio-demographic characteristics and psychosocial indicators. ResultsThe prevalence of antenatal depressive symptoms, using a cut-off of EDS score ≥ 10, was 20.1%. Depressive symptoms were reported more by women of lower family income and had self-reported history of depression prior to pregnancy, with women in the third trimester having higher odds of antenatal depressive symptoms compared to those in the second trimester. Pregnancy-related anxiety, higher perceived stress levels, and post-traumatic stress disorder symptoms were comorbid with the presence of depressive symptoms. ConclusionThe findings showed that one in five pregnant women in Kuwait experiences antenatal depressive symptoms and that these symptoms are comorbid with other mental health problems. Screening for antenatal depression and providing support to pregnant women should be considered.

Group-based multicomponent treatment to reduce depressive symptoms in women with co-morbid psychiatric and psychosocial problems during pregnancy: A randomized controlled trial

BackgroundDepressive symptoms in pregnant women, which are common and debilitating, are often co-morbid with other mental disorders (e.g. anxiety and personality disorders), and related to low socioeconomic status (SES). This situation may hamper treatment outcome, which has often been neglected in previous studies on the treatment of depression during pregnancy. We developed a new group-based multicomponent treatment (GMT) comprising cognitive behavioral therapy, psycho-education and body-oriented therapy and compared the effect on depressive symptoms with individual counseling (treatment as usual, TAU) in a heterogeneous group of pregnant women with co-morbid mental disorders and/or low SES. MethodsAn outpatient sample from a university hospital of 158 pregnant women who met DSM-IV criteria for mental disorders were included and 99 participants were randomized to GMT or TAU from January 2010 until January 2013. The Edinburgh Depression Scale (EDS) was used at baseline, every 5 weeks during pregnancy and as the primary outcome measure of depressive symptoms at 6 weeks postpartum. Secondary outcome measures included the clinician-reported Hamilton Depression Rating Scale (HDRS), obstetric outcomes and a ‘Patient Satisfaction’ questionnaire. Results155 participants were included the intention-to-treat (ITT)-analysis. GMT was not superior above TAU according to estimated EDS (β = 0.13, CI = − 0.46–0.71, p = 0.67) and HDRS scores (β = − 0.39, CI = − 0.82–0.05, p = 0.08) at 6 weeks postpartum. There were no differences in secondary outcomes between the GMT and TAU, nor between the randomized condition and patient-preference condition. LimitationsThe ability to detect an effect of GMT may have been limited by sample size, missing data and the ceiling effect of TAU. ConclusionsGMT is an acceptable treatment for a heterogeneous group of pregnant women with depressive symptoms and co-morbid mental disorders and/or low SES, but not superior to TAU. Further research should focus on understanding and treating co-morbid disorders and psychosocial problems during pregnancy. Clinical trials registrationDutch trial registry, www.trialregister.nl under reference number: NTR3015.

Maternal and Neonatal Outcomes in Multiple Gestations With Elevated Antenatal Edinburgh Depression Scale (EDS) [6R

INTRODUCTION: The purpose of this study was to determine the association of elevated antenatal Edinburgh Depression Scale (EDS) and maternal and neonatal outcomes in multiple gestations, in particular the rate of preterm delivery. METHODS: This is a retrospective study examining multiple gestations delivering at UC San Diego between 2010-2014. Patients were included if they completed an antepartum EDS. An EDS score of &gt;10 was considered positive. The primary outcome was rate of preterm delivery (GA at delivery of &lt; 37 weeks). Other maternal and neonatal outcomes of interest included history of preterm delivery, birth weight percentage and discordance, Apgar score, and maternal weight gain. Data was analyzed using SPPS v.23. RESULTS: 102 women with multiple gestations completed an antepartum EDS. 22.5% (23/102) had a positive EDS score and 77.5% (79/102) had a negative score. Preterm delivery rate in the entire cohort was 61.8% (N=63). Women with an elevated EDS score had a trend toward higher preterm delivery rate (73.9%, N=17) compared to women with lower EDS scores (58.2%, N=46), p-value=0.23. A higher proportion of neonates born to mothers with elevated EDS had an Apgar score less than 7 at 5 minutes (27.3% vs 12.1%, p-value=0.1) although this was not statistically significant. No differences were noted in maternal weight gain or birth weight discordance. CONCLUSION: There is a trend toward an increased rate of preterm delivery and lower Apgar score in multiple gestations with a positive antepartum maternal EDS score. Further studies are needed to assess if treating these high-risk patients reduces their rate of preterm delivery.

The Rate of Elevated Antenatal Edinburgh Depression Score in Pregnancies Complicated by Gestational Diabetes [12Q

INTRODUCTION: The US Preventative Task Force recommends depression screening in pregnancy. The Edinburgh Depression Scale (EDS) is a self-administered screening tool for the diagnosis of depression. An EDS of greater than or equal to 10 is considered elevated and correlated with depression. Despite correlation with depression, maternal and neonatal outcome in high risk populations is unclear. METHODS: This is a retrospective study of singleton pregnancies with gestational diabetes at UC San Diego between 2010-2014 with an antepartum EDS. The primary outcome was the rate of elevated EDS and referral for treatment. The secondary outcomes included maternal characteristics, perinatal outcome, and postpartum follow-up. RESULTS: 210 women met inclusion criteria. 53.2% (107/210) had an elevated EDS score and 71% (76/107) were referred for counseling. Of these, 24.5% (26/76) attended their counseling appointments. 18.7% (20/107) received pharmacologic treatment. Patients with a positive EDS score had a higher rate of PTD (19.6% vs 9.7% (p=0.05)), higher rate of obesity, and less weight gain. No statistical differences were noted in SGA, however, a trend toward a higher rate of these outcomes were noted in the group with elevated EDS (SGA 9.4% vs 2.9% (p=0.08). There were no differences in delivery method, rates of macrosomia, and diabetic control. CONCLUSION: 53% of women with gestational diabetes had an elevated antenatal EDS and approximately 44.9% received treatment. Despite these interventions, a higher rate of PTD and lower weight gain was noted in those with an elevated EDS. Further studies are needed to determine the best intervention and its effect on perinatal outcomes.

The Pregnancy Obsession-Compulsion-Personality Disorder Symptom Checklist

Background: Up until now, very little research has been undertaken on the possible role of personality traits, such as perfectionism and obsessive compulsive personality disorder (OCPD), on pregnancy distress. This is possibly due to the fact that no appropriate instruments are available for use during pregnancy. The current study was undertaken to develop self-rating instruments for assessing symptoms of OCPD (including perfectionism) during gestation, and to evaluate the relationship between high scores on these scales and (recurrent) depression. Method: In a large unselected sample of 1095 pregnant women, the Clinical Perfectionism Scale was adapted and modified to fit into a 15-item perfectionism scale. At the same time, ten questions taken from the SCID OCPD structural interview were modified to fit into a separate self-rating scale. The sample was randomly split into two equal sub-samples: Group I was used for reliability and Explorative Factor Analysis (EFA), and Group II for Confirmative Factor Analysis (CFA). The Edinburgh Depression Scale (EDS), completed at 12, 22 and 32 weeks’ gestation was used to assess concurrent and discriminant validity. Results: A seven-item perfectionism (Eigenvalue: 3.6, 52% explained variance) and seven-item OCPD (Eigenvalue: 3, 40% explained variance) symptom check list retained good psychometric properties: Cronbach’s alpha of 0.85 and 0.78, respectively, and good CFA model fit: a CFI of 0.96, NFI of 0.95, TLI of 0.97, and RMSEA of 0.05, with a lower limit of 0.04; and CFI of 0.97, NFI of 0.97, TLI of 0.98, and RMSEA of 0.05 with a lower limit of 0.03, respectively. Both scales correlated significantly with EDS scores at different trimesters (r: 0.32-0.43). Significantly more often, women with high scores on these scales (defined as a score of >1 SD>mean) reported single and recurrent episodes of depression during gestation and a previous history of depression earlier in life. Conclusion: Self-rating scales that assess OCPD trait symptoms are able to detect women at risk for (recurrent) depression during pregnancy.

Increased levels of depressive symptoms among pregnant women in The Netherlands after the crash of flight MH17.

On July 17, 2014, Malaysia Airlines flight MH17 was shot down, a tragedy that shocked the Dutch population. As part of a large longitudinal survey on mental health in pregnant women that had a study inclusion period of 19 months, we were able to evaluate the possible association of that incident with mood changes using pre- and postdisaster data. We compared mean Edinburgh Depression Scale (EDS) scores from a group of women (n = 126 cases) at 32 weeks' gestation during the first month after the crash with mean scores from a control group (n = 102) with similar characteristics who completed the EDS at 32 weeks' gestation during the same summer period in 2013. The mean EDS scores of the 126 case women in the first month after the crash were significantly higher than the scores of 102 control women. There were no differences in mean EDS scores between the 2 groups at the first and second trimesters. The present study is among the first in which perinatal mental health before and after the occurrence of a disaster has been investigated, and the results suggest that national disasters might lead to emotional responses.

A pilot, exploratory report on dyadic interpersonal psychotherapy for perinatal depression.

Perinatal depression is a major public health burden impacting both mothers and their offspring. The purpose of this study was to develop and test the acceptability and feasibility of a novel psychotherapeutic intervention that integrates an evidence-based intervention for depression, interpersonal psychotherapy (IPT), with postpartum dyadic psychotherapy focused on emotional development in the context of the mother-infant relationship. Nine women between 12 and 30weeks gestation with Edinburgh Depression Scale (EDS) scores >12 were entered into treatment. Three out of nine women dropped out of the study after initiating treatment (one lost to follow-up antepartum; two lost to follow-up postpartum). Seven out of eight women (87%) reported clinically significant improvements in EDS scores from baseline to 37-39weeks gestation, and all women had clinically significant improvements at 12months postpartum. A small randomized controlled trial is underway to further examine the feasibility and acceptability of the intervention.

Worries surrounding the first ultrasound do not bias the screening for depressive and anxiety symptoms during pregnancy.

Antenatal screening for depressive/anxiety symptoms could be biased by worries surrounding the first ultrasound (US). Therefore, we examined the potential influence of worries surrounding the first US on systematic screening for depressive/anxiety symptoms during pregnancy. We obtained data from 573 women screened consecutively in midwifery practices and hospitals in the Netherlands. Data included the Edinburgh Depression Scale (EDS), having had an US, and its perceived influence on women's worries. In total, 18% had EDS scores ≥10 (n=105). Among 392 women who underwent an US, currently existing worries, introduced or unaltered by the US, predicted depressive/anxiety symptoms (aOR: 3.41, P<0.001). Among 181 women who did not undergo an US, expected continuation of existing worries after the US predicted depressive/anxiety symptoms (aOR: 18.84, P=0.046), in contrast to worries which were expected to subside. In our cohort, depressive and/or anxiety symptoms were not associated with transient worries, reduced by a first US, suggesting no bias. If true, antenatal screening for anxiety/depressive symptoms should not depend on the timing of this US examination.

Fear for external cephalic version and depression: predictors of successful external cephalic version for breech presentation at term?

BackgroundObjective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term.MethodsProspective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012. Participants fulfilled The Edinburgh Depression Scale (EDS) questionnaire and expressed their degree of fear on a visual analogue scale from one to ten before ECV. Obstetric factors were evaluated as well. Primary outcome was the relation between psychological factors (fear for ECV and depression EDS scores) and ECV success rate. Secondary outcome was a possible relation between fear for ECV and increased abdominal muscle tension.ResultsThe overall success rate was 55% and was significantly lower (p < 0.001) in nulliparous women (44.3%) compared with parous women (78.0%). Fear for ECV and depression EDS-scores were not related with ECV success rate. Parity, placental location, BMI and engagement of the fetal breech were obstetric factors associated with ECV outcome. There was no relation between fear for ECV and abdominal muscle tone.ConclusionFear for ECV and depression were not related with ECV success rate in this study. Engagement of the fetal breech was the most important factor associated with a successful ECV.Trial registrationEBIS: The Eindhoven Breech Intervention Study, NCT00516555.

Hatha-yoga as a psychological adjuvant for women undergoing IVF: a pilot study

ObjectivesTo evaluate the influence of Hatha-yoga (HY) practice on distress of women before starting their first in vitro fertilization (IVF) cycle. Study designWe offered 143 consecutive women with couple infertility the opportunity to attend a free HY course lasting 3 months as a psychological support before starting their first IVF cycle. All women were asked to complete the State-Trait Anxiety Inventory-Y1 (STAY-Y1), Edinburgh Depression Scale (EDS) and General Health Questionnaire-12 (GHQ-12) at baseline (T1) and after 3 months (T2), to evaluate symptoms of anxiety, depression and distress, respectively. ResultsOf the 143 women, 120 completed all three questionnaires. Of these, 45 attended the HY course and 75 did not. At T1, EDS and GHQ-12 scores were significantly higher in the HY group than in the non-HY group. There were no group differences in STAI-Y1 scores. At T2 there were no group differences. When, in each group, the score of each questionnaire at T1 was compared to the score at T2, a significant T1 to T2 reduction was observed in the HY group (p<0.0001 for STAY-Y1 and GHQ-12, p<0.001 for EDS). ConclusionsOur data suggest that women who are more distressed are more likely to accept psychological support before starting an IVF cycle and that in these women HY practice is associated with distress reduction.

Risk factors for substance use in pregnant women in South Africa

To study the prevalence of alcohol and substance use in a South African antenatal population and its correlates with socio-demographic factors, depression and perceived stress. A prospective self-report study on all women presenting for their first antenatal visit who consented to the study at a midwife obstetric unit (MOU) in the East Metropole district, Cape Town, using the Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Edinburgh Depression Scale (EDS) and Perceived Stress Scale (PSS). Statistical analyses using the chi-square test, separate one-way analyses of variance (ANOVA) and logistic regression analyses were performed as appropriate. Outcome measures were depression, alcohol use and substance use. The questionnaire was completed by 323 women. During pregnancy 36.8% of women smoked, 20.2% used alcohol and 4% used substances. Using EDS cut-off scores of 12 and 15, respectively, 48.9% and 33.6% of the sample had scores consistent with major depression. An EDS cut-off score of 12 was significantly associated with both alcohol use (25.9% v. 15.2%, p=0.019) and risky drinking (76.9% v. 36.8%, p=0.04), while an EDS cut-off score of 15 was significantly associated with substance use (8.2% v. 1.4%, p=0.004) as well as alcohol dependence (23.1% v. 3.1%). We found high rates of both alcohol abuse and antenatal depression, and a significant association between depression, substance use and alcohol abuse; EDS scores greater than 12 could be used to identify women at risk of alcohol dependence and/or substance abuse.

Postnatal Depression and Socio-Demographic Risk: Factors Associated with Edinburgh Depression Scale Scores in a Metropolitan Area of New South Wales, Australia

The aim of this study was to determine the prevalence and risk factors for postnatal depressive symptoms in women living in metropolitan Sydney, Australia. A population-based cross-sectional study of mothers of newborn infants was undertaken during home and community clinic visits in South West Sydney from 2000 to 2004. A comprehensive 45 item survey questionnaire was completed by 29 405 mothers. A self-report Edinburgh Postnatal Depression Scale (EPDS) of depressive symptoms was completed by 25 455 mothers at the first child and family nurse visit. The primary study outcome measures were EPDS scores greater than 9 and greater than 12. At a mean infant age of 2.16 weeks the prevalence of EPDS >9 was 12% and EPDS >12 was 6.2%. Results from multiple logistic regression revealed that EPDS >9 and EPDS > 2 were associated with a maternal country of birth other than Australia, difficult financial situation, living in the suburb one year or less, 'no regret leaving the suburb', unplanned pregnancy, not breastfeeding, and poor rating of mother's own health. Other social demographic factors such as marital status, maternal age, education of mother, or being Aboriginal or a Torres Strait Islander show no significant association with postnatal depressive symptoms. The results confirm prevalence rates and maternal individual-level risk factors from previous studies. The study contributes to the limited number of studies of postnatal depression and socio-demographic factors. Neighbourhood and community group-level factors may be important and should be studied further.

Validation of the Edinburgh Depression Scale during pregnancy

Background Untreated depression during pregnancy may have adverse outcomes for the mother and her child. Screening for depression in the general pregnant population is thus recommended. The Edinburgh Depression Scale (EDS) is widely used for postpartum depression screening. There is no consensus on which EDS cutoff values to use during pregnancy. The aim of the current study was to examine the predictive validity and concurrent validity of the EDS for all three trimesters of pregnancy. Methods In a large unselected sample of 845 pregnant women, the sensitivity, specificity, and validity of the EDS were evaluated. The Composite International Diagnostic Interview (depression module) was used to examine the predictive validity of the EDS. The anxiety and somatization subscales of the Symptom Checklist 90 (SCL-90) were used to examine its concurrent validity. Only women with a major depressive episode were considered as cases. Results The prevalence of depression decreased toward end term: 5.6%, 5.4%, and 3.4%. The EDS scores also decreased toward end term, while the SCL-90 subscale anxiety scores increased. The EDS showed high test–retest reliability and high concurrent validity with the SCL-90 anxiety and somatization subscales. The area under the receiver operating characteristic curve was high and varied between 0.93 and 0.97. A cutoff value of 11 in the first trimester and that of 10 in the second and third trimesters gave the most adequate combination of sensitivity, specificity, and positive predictive value. Conclusions The EDS is a reliable instrument for screening depression during pregnancy. A lower cutoff than commonly applied in the postpartum period is recommended.

Treating infant sleep disturbance: Does maternal mood impact upon effectiveness?

To explore whether mild-to-moderate maternal depression affects the effectiveness of a behavioural approach to treating infant sleep disturbance (ISD). The health records of 90 mothers attending an inpatient parenting service for management of their 5-12-month-old infant's sleep difficulties were examined. These records contained detailed, nurse-completed, 24-hour behaviour charts of infant sleeping and crying. Participants were allocated to the depression group based on Edinburgh Depression Scale score and/or review of mental health assessment notes. There were no differences between infants of mothers with (n= 39) or without (n= 51) depression on either (i) the severity of their initial sleeping difficulty, or (ii) their response to behavioural treatment. Both groups showed significant improvements over the 5-day stay on all sleep variables observed, including number of night wakings, time to fall asleep, time spent crying at night and total time slept at night. Mild-to-moderate maternal depression does not appear to attenuate ISD behavioural treatment outcomes. Given ISD treatment has been shown to improve maternal mood, the results of this study argue against recommendations initially to address maternal mood in isolation when managing ISD.