Darwin, Z, McGowan, L and Edozien, LC (2015) Identification of women at risk of depression in pregnancy: using women’s accounts to understand the poor specificity of the Whooley and Arroll case finding questions in clinical practice. Archives of Women's Mental Health. ISSN 1434-1816
Abstract
Antenatal mental health assessment is increasingly common in high-income countries. Despite lacking evidence on validation or acceptability, the Whooley questions (modified PHQ-2) and Arroll ‘help’ question are used in the UK at booking (the first formal antenatal appointment) to identify possible cases of depression. This study investigated validation of the questions and women’s views on assessment. Women (n = 191) booking at an inner-city hospital completed the Whooley and Arroll questions as part of their routine clinical care then completed a research questionnaire containing the Edinburgh postnatal depression scale (EPDS). A purposive subsample (n = 22) were subsequently interviewed. The Whooley questions ‘missed’ half the possible cases identified using the EPDS (EPDS threshold ≥10: sensitivity 45.7 %, specificity 92.1 %; ≥13: sensitivity 47.8 %, specificity 86.1 %), worsening to nine in ten when adopting the Arroll item (EPDS ≥10: sensitivity 9.1 %, specificity 98.2 %; ≥13: sensitivity 9.5 %, specificity 97.1 %). Women’s accounts indicated that under-disclosure relates to the context of assessment and perceived relevance of depression to maternity services. Depression symptoms are under-identified in current local practice. While validated tools are needed that can be readily applied in routine maternity care, psychometric properties will be influenced by the context of disclosure when implemented in practice.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2015, Springer. This is an author produced version of a paper published in Archives of Women's Mental Health. Uploaded in accordance with the publisher's self-archiving policy. The final publication is available at Springer via http://dx.doi.org/10.1007/s00737-015-0508-1 |
Keywords: | Mixed methods; Perinatal mental health; Pregnancy; Screening; Whooley questions |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Midwifery (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Apr 2015 11:28 |
Last Modified: | 08 Mar 2016 13:23 |
Published Version: | http://dx.doi.org/10.1007/s00737-015-0508-1 |
Status: | Published |
Publisher: | Springer-Verlag Wien |
Identification Number: | 10.1007/s00737-015-0508-1 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:84042 |