The prediction of antenatal and postnatal depression in a sample of Western Australian women

In Australia, the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden & Sagovsky, 1987) has been increasingly used to screen for antenatal depression prior to its evaluation on a sample of Australian pregnant women. Also, the identification of predictors associated with antenatal depression has been neglected relative to the research focus on postpartum depression. An aim of the study was to evaluate the antenatal screening properties of the EPDS against diagnoses of major depression with the Mini International Neuropsychiatric Interview (MINI; Sheehan eta!., 1998). The aims were also to develop predictive models of risk factors associated with antenatal depression as measured by: (a) diagnosis of major depression (MINI); (b) depressive symptoms (EPDS 2: 9); (c) depression false positive results (EPDS 2:9, but no MINI diagnosis of major depression); and (d) depression level (EPDS total score) in the antenatal and early postnatal period. The study was prospective in design, with 200 women enrolled from Western Australia\u27s largest public maternity hospital. An EPDS 2: 12 was identified to be optimum for the clinical screening of major depression at 32 weeks of pregnancy. The results from the different regression analyses showed that the strongest predictors of antenatal depression were: depression earlier in pregnancy, anxiety, stress, daily hassles, expectations of support, personality traits, and history variables. The findings were in support of routine screening for depression and anxiety during pregnancy, the effects of stress on mood, and the lesser importance of antenatal compared to postnatal variables in accounting for postpartum depression level