One Question Can Help Identify Pregnant Women at Risk for Depression

Pregnant women are at increased risk for significant mood swings due to hormonal changes. After giving birth, women experience physiologic and emotional changes that can also influence moods. All of these factors contribute to the development of depression in some women. Antenatal and postpartum depression both pose significant health risks to the mother and child. Children of depressed mothers are more likely to experience abuse in the form of neglect or maltreatment than those of nondepressed mothers. Children of depressed mothers also have a greater risk of cognitive and behavioral developmental delays. The importance of identifying and treating these women cannot be overemphasized. However, the current assessment methods often result in inconsistent diagnoses.

In an effort to more accurately identify those women at risk for depression before and after childbirth, Rachel Mann of the Department of Health Sciences at the University of York in the UK recently conducted a study of 152 expectant mothers before and after delivery. Mann evaluated the responses to two questions that are used in triage care for depressed women. She then had the women answer a third question. Specifically, she asked the women if they believed they needed help for their depressed moods.

With the addition of this third question, Mann was able to eliminate any false-positive responses. This one question allowed Mann and her colleagues to identify the women most at risk for depression and distinguish them from those who were merely experiencing the normal, although sometimes extreme, mood swings that can accompany pregnancy and childbirth. Mann believes that this additional question, if used in conjunction with existing screening tools, could significantly decrease the number of incorrect depression diagnoses among pregnant women. “Identification of perinatal depression is important but represents only the first step,” said Mann. “It must be followed by confirmation of the diagnosis and appropriate treatment or referral.”

Mann, R., Adamson, J., Gilbody, S. M. (2012). Diagnostic accuracy of case-finding questions to identify perinatal depression: CMAJ. Canadian Medical Association Journal 184.8, E424-430.

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  • gina


    June 13th, 2012 at 3:35 PM

    But what about those superwomen moms, the ones who don’t think that they need any help with anything and that they can do it all?
    Come on, we all know those women and they really drive me kind of crazy. They will never ask for any help, even when they clearly need it but go through life acting put upon like a saint and making the rest of us moms feel bad about ourselves!
    No, I really do want them to get the help that they need, but you have to be careful with this one because there are always going to be those women who will have ahrd time admitting that they need some help in the realm of mom-hood where they derive the very sense of who they are and that image that they want to project to everyone else.

  • Chris


    June 13th, 2012 at 5:22 PM

    It is imperative that providers get a better handle on the women who are more likely to experience postpartum depression before they even leave the hospital. I realize that it will not be foolproof, but it might help to save lives. It may indicate a far greater number of women who are susceptible to this sort of depression than we would have otherwise have known. If a better job is done at doing this then the women can get help sooner than they may have gotten help before. And actually be able to enjoy motherhood again!

  • Frank p

    Frank p

    June 14th, 2012 at 5:27 AM

    Have there ever been any studies that compare the rates of depression in pregnant married women versus pregnant women who are single?
    I would like to see how those two compare. Not that this is an excuse to just get married, but you would have to think that the numbers of this could be lower in those who are happily in a relationship with someone versus trying to go it alone.

  • Megan


    June 15th, 2012 at 1:45 AM

    I have 2 daughters. I experienced many health problems during pregnancy w/ my 1st, but no post partem depression. She has completely normal if not exceeding milestones reached, no developmental or behavioral delays. With my 2nd daughter, I suffered HORRIBLE pp depression & chronic anxiety. This daughter has a nearly 50% delay is almost all
    Areas of development, other than growth and domestic skills. She Has Sensory Integration Dysfunction, severe Auditory Processing problems, is “hard sensory,” etc.. She qualifies for special education & SSI under the Citizens w/ Disabilities Act. The statement above aboUt how post partem depression sticken women are more likely to have cognitive & behavioral development delays really hits home for me.
    I really wish that personal, couple & family counseling were offered to post natal women & their families.

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