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A Simplified Predictive Index for the Detection of Women at Risk for Postnatal Depression

Authors

  • Joan Webster RN RM BA,

    1. Joan Webster is Director, Nursing & Women's Health Research Centre, Royal Women's Hospital; Margo Pritchard is Clinical Trials Coordinator, Perinatal Research Centre, Royal Women's Hospital; Debra Creedy is Professor of Nursing, Faculty of Nursing & Health Griffith University; and Chris East is Research Midwife, Perinatal Research Centre, Royal Women's Hospital, Brisbane, Queensland, Australia.
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  • Margo A. Pritchard RN BA,

    1. Joan Webster is Director, Nursing & Women's Health Research Centre, Royal Women's Hospital; Margo Pritchard is Clinical Trials Coordinator, Perinatal Research Centre, Royal Women's Hospital; Debra Creedy is Professor of Nursing, Faculty of Nursing & Health Griffith University; and Chris East is Research Midwife, Perinatal Research Centre, Royal Women's Hospital, Brisbane, Queensland, Australia.
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  • Debra Creedy RN BA(Hons) PhD,

    1. Joan Webster is Director, Nursing & Women's Health Research Centre, Royal Women's Hospital; Margo Pritchard is Clinical Trials Coordinator, Perinatal Research Centre, Royal Women's Hospital; Debra Creedy is Professor of Nursing, Faculty of Nursing & Health Griffith University; and Chris East is Research Midwife, Perinatal Research Centre, Royal Women's Hospital, Brisbane, Queensland, Australia.
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  • Chris East RN RM MMedSc

    1. Joan Webster is Director, Nursing & Women's Health Research Centre, Royal Women's Hospital; Margo Pritchard is Clinical Trials Coordinator, Perinatal Research Centre, Royal Women's Hospital; Debra Creedy is Professor of Nursing, Faculty of Nursing & Health Griffith University; and Chris East is Research Midwife, Perinatal Research Centre, Royal Women's Hospital, Brisbane, Queensland, Australia.
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Address correspondence to Joan Webster, Nursing & Women's Health Research Centre, 6th Floor Ned Hanlon Building, Royal Women's Hospital, Herston, Queensland 4029, Australia.

Abstract

Background: Many women who suffer from postnatal depression are never diagnosed or treated. The objective of this study was to develop an index for use in maternity settings that identifies women who may be at risk for postnatal depression.

Methods: Women (n = 1762) attending the ‘‘booking-in’’ clinic were screened for antenatal risk factors for postnatal depression. On the third postnatal day eligible women were screened for postnatal risk factors. The Edinburgh Postnatal Depression Scale was mailed to participants16 weeks after the birth. A predictive index was developed, based on the mean Edinburgh Postnatal Depression Scale scores for each risk factor. The sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the diagnostic value of the index.

Results: Seven hundred and twenty-three (50.1%) of the eligible women completed all phases of the study. Of this group, 93 (12.2%) women scored higher than 12 on the Edinburgh Postnatal Depression Scale. At a cutoff of 6, the index had positive predictive value of 39.8 percent for postnatal depression, a threefold improvement over the base rate.

Conclusion: The Brisbane Postnatal Depression Index provides a clinically useful method for identifying women at risk for developing postnatal depression. It has applications for early intervention or to identify high-risk groups for research purposes. (BIRTH 30:2 June 2003)

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