Adding perinatal anxiety screening to depression screening: is it worth it?

Area of Science:

• Perinatal mental health
• Clinical screening protocols
• Anxiety and depression disorders

Background:

• Peripartum depression screening is standard care, but research on peripartum anxiety screening is limited.
• Existing clinical practice includes depression screening using the Patient Health Questionnaire-2 (PHQ-2) at prenatal visits.
• There is a need to evaluate the impact of incorporating anxiety screening into routine perinatal care.

Purpose of the Study:

• To determine if adding perinatal anxiety screening enhances the identification of women eligible for mental health support.
• To assess the effectiveness of a combined depression and anxiety screening protocol.

Main Methods:

• A prospective study comparing two screening groups: PHQ-2 only versus PHQ-2 plus Generalized Anxiety Disorder 2-item (GAD-2) scale.
• Screenings were conducted at 24-28 weeks gestation during prenatal visits.
• Primary outcome was the rate of positive depression and anxiety screens; secondary outcomes included mental health referrals and clinical outcomes.

Main Results:

• The PHQ-2+GAD-2 group identified more positive screens for anxiety (4) and depression (5) compared to the PHQ-2 only group (2 positive depression screens).
• Three women screened positive for anxiety but negative for depression.
• Referral rates significantly increased for subgroups with a history of mental health diagnosis or substance abuse when anxiety screening was included.

Conclusions:

• Perinatal anxiety screening can improve the identification and referral of women with mood and anxiety disorders.
• Anxiety screening is particularly valuable for high-risk populations, including those with prior mental health issues or substance use.
• Further research is needed to optimize the implementation of perinatal anxiety screening.