Screening for anxiety disorders in third trimester pregnancy: a comparison of four brief measures.

Evidence regarding the accuracy of existing anxiety screeners used in pregnancy is limited. This study compares the psychometric characteristics of the Generalized Anxiety Disorder 2- and 7-item Scales (GAD-2 and GAD-7), the anxiety subscale of the Edinburgh Postnatal Depression Scale (EPDS-3A) and the two anxiety items of the Antenatal Risk Questionnaire (ANRQ-2A). Nine hundred fifty-four women completed the screening measures and anxiety modules of a diagnostic reference standard (SAGE-SR) in the third trimester.

Disclosure of sensitive material at routine antenatal psychosocial assessment: The role of psychosocial risk and mode of assessment.

Problem: While routine psychosocial assessment is acceptable to most pregnant women, some women will not fully disclose psychosocial concerns to their clinician.

Aims: To assess the impact of psychosocial risk, current symptoms and mode of assessment on women's honesty of disclosure at psychosocial assessment.

Methods: Logistic regression was used to examine associations between disclosure and a range of psychosocial characteristics in women who were 'always honest' and 'not always honest'.

Why do some pregnant women not fully disclose at comprehensive psychosocial assessment with their midwife?

Problem: While comprehensive psychosocial assessment is recommended as part of routine maternity care, unless women engage and disclose, psychosocial risk will not be identified or referred in a timely manner. We need to better understand and where possible overcome the barriers to disclosure if we are to reduce mental health morbidity and complex psychosocial adversity.

Aims: To assess pregnant women's attitude to, and reasons for non-disclosure at, comprehensive psychosocial assessment with their midwife.

Detection and management of mood disorders in the maternity setting: the Australian Clinical Practice Guidelines.

Background: Mood disorders arising in the perinatal period (conception to the first postnatal year), occur in up to 13% of women. The adverse impact of mood disorders on mother, infant and family with potential long-term consequences are well documented. There is a need for clear, evidence-based, guidelines for midwives and other maternity care providers.

Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection?

The objectives of this study were: (1) to examine Composite International Diagnostic Interview (CIDI) period prevalence and comorbidity for depression and anxiety disorder in a cohort of women assessed during the first 6-8 months postpartum and (2) to examine the benefits of combining the Edinburgh Postnatal Depression Scale (EPDS) with a simple "interval symptom" question to optimize screening postpartum. Women aged over 18 (N = 1,549) were assessed during late pregnancy and reviewed at approximately 2, 4, and 6-8 months postpartum using the EPDS and an "interval symptom" question. The latter asked about any depressive symptoms in the interval since the last EPDS.

Postnatal mental health of women giving birth in Australia 2002-2004: findings from the beyondblue National Postnatal Depression Program.

Objectives: To describe the postnatal mental health status of women giving birth in Australia 2002-2004 at 6-8 weeks postpartum.

Method: Women were recruited from 43 health services across Australia. Women completed a demographic questionnaire and an Edinburgh Postnatal Depression Scale (EPDS) in pregnancy; the latter was repeated at 6-8 weeks following childbirth.

When euthymia is just not good enough: the neuropsychology of bipolar disorder.

Bipolar disorder (BD) is a debilitating psychiatric illness that is uniquely characterized by switching between psychopathologically contrasting phases of mania and depression, often with intervening periods of euthymia. However, these periods of apparent clinical recovery (euthymia) are marked by subtle social, occupational, and cognitive impairments, profiled by recent neuropsychological investigations. Determining the cognitive changes across these three phases may help differentiate the disruptions that are mood state-dependent from those associated with underlying pathology.

Severity of stressful life events in first and subsequent episodes of depression: the relevance of depressive subtype.

Background: Recent studies have reignited debate concerning the relationship between stressful life events and depressive subtypes, particularly in relation to first versus subsequent episodes.

Aims: To investigate the relationship between stressful life events and variably defined melancholic/non-melancholic depressive subtypes, and the import of such life events to first compared with subsequent episodes across those subtypes.

Method: Acute and chronic stressful life events were rated in 270 patients with DSM-IV Major Depressive episodes who were allocated to melancholic and non-melancholic groups separately as defined by DSM-III-R, DSM-IV, the Newcastle criteria and the CORE system.

To screen or not to screen--that is the question in perinatal depression.

Significant perinatal distress and depression affects 14% of women, producing short and long term consequences for the family. This suggests that measures for early detection are important, and non-identification of these women may exacerbate difficulties. Screening provides an opportunity to access large numbers of women and facilitate pathways to best-practice care.