The acceptability of case-finding questions to identify perinatal depression
Guidance from the National Institute for Health and Care Excellence advocates the use of two case-finding questions about depressed mood and loss of interest in activities to identify perinatal depression. However, there are no studies of their acceptability when administered in the antenatal and postnatal period.
The study was an intra-mixed methods cohort study set in an antenatal clinic in an inner-city hospital in the North of England. Pregnant women attending a routine antenatal appointment at approximately 26 weeks' gestation completed a self-report survey at a routine hospital antenatal appointment and a postal survey between 5 and 13 weeks postnatal. Survey responses and free-text commentaries of women's views were analysed using descriptive statistics and qualitative content analysis.
Ninety-three percent of participants felt it was desirable to ask about perinatal mental wellbeing, and 97% felt comfortable answering the questions. Free-text comments revealed depressed and non-depressed women found the questions easy, simple and straightforward to answer.
Case-finding questions to identify perinatal depression were generally acceptable to depressed and non-depressed pregnant and newly delivered mothers. Health professionals should consider the acceptability and appropriateness of this strategy in order to facilitate identification of perinatal mental health issues in routine maternity care practice.
Perinatal depression has been defined as encompassing ‘major and minor depressive episodes that occur either during pregnancy or within the first 12 months after delivery’ (Gavin et al, 2005: 1071), and includes new episodes of depression and pre-existing depression (Matthey, 2004). It is important to identify perinatal depression as there is evidence to suggest it is associated with self-reported poor maternal health in pregnancy (Orr et al, 2007) poor obstetric and neonatal outcomes (Marcus, 2009) and has a substantial impact on the mother and her partner (Boath et al, 1998), mother–baby interaction (Murray et al, 1996) and the longer-term emotional and cognitive development of the infant (Mensah and Kiernan, 2011). However, it is estimated that less than 50% of cases of maternal depression are identified in routine clinical practice (Oates et al, 2011).
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