What is the best tool for screening antenatal depression?

Area of Science:

• Obstetrics and Gynecology
• Psychiatry
• Clinical Psychology

Background:

• Antenatal depression (AD) poses significant risks, yet no specific scales exist for its measurement.
• Current practice involves adapting scales designed for other conditions, potentially limiting accuracy.
• This study aimed to validate psychometric properties of screening tools for AD in Brazil.

Purpose of the Study:

• To validate and assess the psychometric properties of commonly used depression screening scales for antenatal depression (AD) in Brazil.
• To determine the effectiveness of the MINI-PLUS, Edinburgh Depression Scale (EPDS), Beck Depression Inventory (BDI), and Hamilton Depression Rating Scale (HAM-D) for AD screening.
• To identify optimal cut-off scores for these scales in a Brazilian pregnant population.

Main Methods:

• Cross-sectional study involving pregnant women in their second trimester.
• Clinical and socio-demographic data collection.
• Administration of MINI-PLUS, EPDS, BDI, and HAM-D for depression assessment.

Main Results:

• Prevalence of current depression was 17.34%; lifetime major depression was 31.98%.
• All tested instruments demonstrated high diagnostic accuracy (Area Under Curve > 0.85).
• The BDI showed the highest performance (AUC=0.90). Optimal cut-off scores were identified for EPDS (≥11), BDI (≥15), and HAM-D (≥9) with good sensitivity and specificity.

Conclusions:

• Antenatal depression is highly prevalent in Brazil.
• The EPDS, BDI, and HAM-D are effective tools for identifying AD in this population.
• Physicians can utilize these validated scales to improve the recognition and management of antenatal depression.