Diagnostic accuracy of case-finding questions to identify perinatal depression

Article Figures & Tables

Table 1:

Characteristics of study participants

Characteristic	No. (%) of patients^* n = 152
Age, yr, mean (SD)	27.4 (5.8)
Ethnic background
White British	81 (53.3)
White other	5 (3.3)
Mixed (white and black)	4 (2.6)
Mixed (white and South Asian)	3 (2.0)
Black	6 (3.9)
Indian	5 (3.3)
Pakistani	38 (25.0)
Bangladeshi	5 (3.3)
Other	5 (3.3)
Primiparous	73 (48.0)
Marital status
Married, first marriage	79 (52.0)
Remarried	10 (6.6)
Single, never married	60 (39.9)
Divorced	3 (2.0)
Cohabitation
Lives with baby’s father	122 (80.3)
Lives with another partner	1 (0.7)
In a relationship, not living with partner	20 (13.2)
Not in a relationship	9 (5.9)
Housing
Owns house, paying mortgage/loan	68 (44.7)
Owns house outright	13 (8.6)
Rents	54 (35.5)
Lives rent free	17 (11.2)
Highest level of education
None	22 (14.5)
High school	35 (23.0)
College or university	31 (20.4)
Postgraduate school	49 (32.2)
Other	12 (7.9)
No response	3 (2.0)
Employment status
Currently employed	94 (61.8)
Previously employed	34 (22.4)
Never employed	24 (15.8)
Smoking status
Current smoker	22 (14.5)
Former smoker	42 (27.6)
Never smoked	88 (57.9)
Self-reported history of diagnosed depression
No prior diagnosis by general practitioner	128 (84.2)
≥ 1 diagnosed episode of depression	24 (15.8)

Table 2:

Performance of two case-finding questions (index test) and an additional question about the need for help in identifying perinatal depression

Measure	Antenatal phase		Postnatal phase

	Case-finding questions^* n = 126^†	Question about need for help^‡ n = 52	Case-finding questions^* n = 94^†	Question about need for help^‡ n = 45
True positive, no.	17	10	18	7

False negative, no.	0	7	0	11

True negative, no.	74	32	49	27

False positive, no.	35	3	27	0

Sensitivity, % (95% CI)	100 (77–100)	58 (38–76)	100 (78–100)	39 (18–64)

Specificity, % (95% CI)	68 (58–76)	91 (78–97)	65 (53–75)	100 (85–100)

Positive likelihood ratio (95% CI)	3.03 (2.28–4.02)	6.86 (2.16–21.7)	2.73 (2.0–3.74)	21.4 (1.3–354.2)

Negative likelihood ratio (95% CI)	0.041 (0.003–0.63)	0.45 (0.25–0.80)	0.042 (0.003–0.65)	0.62 (0.43–0.90)

Note: CI = confidence interval.
↵* There were no missing responses to the case-finding questions. A positive response to either of the two questions was considered a positive screen.
↵† This is the number of women who also completed the telephone interview. A total of 152 women (antenatal phase) and 97 women (postnatal phase) answered the case-finding questions.
↵‡ Responses to an additional question about the need for help were elicited only from participants with a positive response to either of the case-finding questions.

Table 3:

Characteristics of the 94 women who participated in the postnatal phase of the study and the 52 women who did not

Characteristic	Participation in postnatal phase; no. (%) of women^*		p value^§
Characteristic	Participated^† n = 94	Did not participate^‡ n = 52	p value^§
Age, yr, mean (SD)	28.5 (6.2)	25.4 (4.4)	0.002
White	58 (62)	25 (48)	0.1
Primiparous	48 (51)	21 (40)	0.2
Married	60 (64)	25 (48)	0.06
Living with baby’s father or another partner	81 (86)	38 (73)	0.05
House owner	47 (50)	18 (35)	0.07
Attended school (any level)	76 (81)	33 (64)	0.02
Currently employed	65 (69)	25 (48)	0.01
Nonsmoker during pregnancy^¶	84 (89)	43 (83)	0.3
Self-reported history of ≥ 1 diagnosed episodes of depression	16 (17)	6 (12)	0.4

Note: SD = standard deviation.
↵* Unless stated otherwise.
↵† Completed the questionnaire in both the antenatal and postnatal phases and completed the telephone interview.
↵‡ Completed the questionnaire in the antenatal phase only (49 did not respond to any postnatal contact and 3 did not complete the postnatal telephone interview).
↵§ Values were compared by means of the t test and χ² test.
↵¶ Includes former smokers and those who never smoked.