Proposing a two-stage screening approach to distinguish between transient and enduring postnatal depressive symptoms: A prospective cohort study.

Background: Screening for perinatal depression using the Edinburgh Postnatal Depression Scale (EPDS) improves detection and increases health service utilization. However, previous studies with antenatal samples indicate that positive screenings might reflect transient distress that resolves without intervention, raising concerns about over-pathologizing typical postnatal responses and inefficiencies in referral practices. Therefore, distinguishing between transient and enduring depressive symptoms for appropriate referrals to secondary services is crucial, highlighting the need for a refined screening practice.

Is Validating the Cutoff Score on Perinatal Mental Health Mood Screening Instruments, for Women and Men from Different Cultures or Languages, Really Necessary?

: The most commonly used mood screening instrument in perinatal health is the Edinburgh Depression Scale. The screen-positive cut-off score on this scale, as for others, has been determined, via validation techniques, for over 20 languages/cultures, and for both women and men. While such validation appears to be considered essential, there are studies that could be interpreted to suggest that this is not an important consideration.

Screening women for distress during pregnancy: the impact of including 'Possibly' as a response option.

Objectives: To investigate the impact of including the response option of 'Possibly' in the Distress question on the Matthey Generic Mood Questionnaire (MGMQ) during antenatal emotional health screening in English-speaking women.

Background: Some distress screening questions only allow respondents to choose between 'Yes' or 'No' to the presence of distress. The MGMQ, however, allows respondents to chose between 'Yes', 'Possibly', or 'No', which may be preferable if a participant is reluctant to state she definitely feels distressed.

Women's interpretation, understanding and attribution of the anhedonia question in the PHQ-4 and modified-Whooley questions in the antenatal period.

Objectives: To report on the rates of misinterpretation, confusion, and attribution of the anhedonia question in the PHQ-4 and Whooley questions by pregnant women.

Background: The NICE Perinatal Mental Health guidelines recommend the use of the anhedonia question for depression screening, yet evidence suggests it may be misinterpreted or not be related to mood.

Method: Women attending a public hospital's antenatal clinic, communicating in English as their language of choice, completed either the PHQ-4 or the Whooley questions.

PASTEC - a prospective, single-center, randomized, cross-over trial of pure physical versus physical plus attentional training in children with cancer.

Despite recent improvements in survival rates in children with cancer, long-term toxicities remain a major concern. Physical activity could reduce the impact of long-term sequelae, notably in neuropsychological and physical areas. We report of a randomized trial of pure physical versus physical/attentional training in pediatric oncology patients.

Depression in pregnancy "strongly predicts" depression postpartum: Are we inadvertently misleading clinicians and researchers?

Background: Many perinatal mental health risk factor studies report that antenatal depression is a signifcant risk factor for women being depressed postnatally. They often describe the strength of the risk as being 'strong' or 'strongly predictive' (or similar phrases), though usually without explaining why these terms are used. It is possible that readers of such research may misunderstand these qualitative descriptors.

An exploratory and confirmatory factor analysis study of the EPDS in postnatal Italian-speaking women.

Background: Depression and anxiety are the most prevalent emotional difficulties in the perinatal period and there is agreement that early intervention is an important strategy to prevent long-lasting effects on mother and child. Literature has recently shown that the Edinburgh Postnatal Depression Scale (EPDS) is able to measure not only depression but also anxiety.

Objective: To investigate the factorial structure of the EPDS in Italian-speaking new mothers.

Increasing partner communication and understanding during pregnancy: evaluation of 'The Great Pregnancy Quiz'.

Objective: To evaluate a Quiz designed to enhance communication and understanding in expectant parents.

Background: A supportive and understanding relationship is associated with better maternal mental health outcomes. Many services therefore advocate that couples should communicate openly with each other, particularly about worries or concerns either have.

Validation of the MGMQ in screening for emotional difficulties in women during pregnancy.

Background: Screening for emotional health difficulties in pregnant or postpartum women is becoming routine practice in health services. This screening is often done using the EPDS, usually using a screen positive score just to identify possible depression. This and other such scales often have a myriad of screen-positive scores, making them impractical within clinical settings.

Transient vs enduring distress in late pregnancy using the EPDS: a brief longitudinal exploratory study.

: The Edinburgh Postnatal Depression Scale (EPDS) is widely used to detect perinatal distress in women by one single administration. Recently, research has shown that during early pregnancy around half of the women scoring as 'possibly depressed' on the EPDS only have transient distress, when re-tested after few weeks. This finding may not occur if women are screened later in pregnancy, as their worries then may be more enduring; therefore an exploratory study was conducted to further investigate this issue.

Is pregnancy-specific anxiety more enduring than general anxiety using self-report measures? A short-term longitudinal study.

: To investigate whether the rates of transient and enduring distress differ between general and pregnancy-specific anxiety in antenatal English-speaking women. : Evidence indicates that half of women with high levels of general anxiety during pregnancy will no longer be highly anxious after a few weeks, without having received treatment. Pregnancy-specific anxiety, however, may be more enduring, as many worries concerning the forthcoming birth, whether the baby will be healthy and the woman's ability to care for a newborn are likely to continue, or increase, during the pregnancy.

Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression.

Background: The Edinburgh Postnatal Depression Scale (EPDS) is widely used in many countries to screen women for depression in the perinatal period. However, across studies the psychometric properties and cutoff scores of the EPDS have varied considerably; potentially due to different depression criteria and diagnostic systems being used. Therefore, we validated the Danish EPDS against a depression diagnosis according to both DSM-5 and ICD-10.

A comparison of the interviewer-administered phone and self-complete online versions of the computerized eMINI 6.0 in a sample of pregnant women.

Background: This study compares the prevalence rates of depressive and anxiety disorders identified during pregnancy using an interviewer-administered phone version and a self-complete online version of the computerized eMINI 6.0.

Methods: 888 pregnant women completed the computerized eMINI 6.

A comparison of two measures to screen for emotional health difficulties during pregnancy.

Objective: To compare the performance of a generic mood questionnaire (Matthey Generic Mood Questionnaire, MGMQ) against the established Edinburgh Postnatal Depression Scale (EPDS) in perinatal mental health mood screening.

Background: Many perinatal clinical services use the EPDS to screen for depression, and some may consider using it to screen for anxiety. A new scale, the MGMQ, is designed to screen for a wide variety of emotions, not just depression or anxiety.

A comparison of the PHQ-2 and MGMQ for screening for emotional health difficulties during pregnancy.

Background: Routine screening for emotional health difficulties in women during pregnancy is now advocated in several countries. There is a need therefore to compare the performance of different self-report measures to accomplish this. This study reports on the comparative performance of two such measures- the well-established PHQ-2, which aims to detect depression, and the more recent MGMQ, which aims to detect a wide array of negative emotions.

Study protocol for a comparative effectiveness trial of two models of perinatal integrated psychosocial assessment: the PIPA project.

Background: Studies examining psychosocial and depression assessment programs in maternity settings have not adequately considered the context in which psychosocial assessment occurs or how broader components of integrated care, including clinician decision-making aids, may optimise program delivery and its cost-effectiveness. There is also limited evidence relating to the diagnostic accuracy of symptom-based screening measures used in this context. The Perinatal Integrated Psychosocial Assessment (PIPA) Project was developed to address these knowledge gaps.

Using the Edinburgh Postnatal Depression Scale for women and men-some cautionary thoughts.

The objective of the study was to critically consider some of the possible limitations in the Edinburgh Depression Scale (EDS), given that great emphasis is put on the results of this measure within both clinical and research fields. Using findings and discussion points from other studies, as well as from a critical analysis of issues by the authors based upon their clinical and research experience, possible limitations with the scale in nine areas are discussed. Possible limitations include the following: (1) ambiguous items, (2) exclusion of certain types of distress, (3) scoring difficulties, (4) low positive predictive value, (5) frequent use of incorrect cut-off scores, (6) a vast array of validated cut-off scores, (7) validation against a questionable gold-standard, (8) limited anxiety detection and of depressive symptoms in men, and (9) many screen positive women only have transient distress.

Antenatal psychosocial risk status and Australian women's use of primary care and specialist mental health services in the year after birth: a prospective study.

Background: Poor mental health in the perinatal period can impact negatively on women, their infants and families. Australian State and Territory governments are investing in routine psychosocial assessment and depression screening with referral to services and support, however, little is known about how well these services are used. The aim of this paper is to report on the health services used by women for their physical and mental health needs from pregnancy to 12 months after birth and to compare service use for women who have been identified in pregnancy as having moderate-high psychosocial risk with those with low psychosocial risk.

Differentiating between Transient and Enduring distress on the Edinburgh Depression Scale within screening contexts.

Background: Research has shown that women screened as being 'possibly depressed' on the Edinburgh Depression Scale consist of two distinct duration types: those with Transient distress, and those with Enduring distress. This paper reports on the exploration of antenatal data to ascertain if information from the initial EDS screening can help determine which women may have Transient, and which Enduring, distress after just a few weeks.

Methods: Data from three antenatal studies were explored, where the EDS had been given twice within a psychosocial screening setting.

Routine antenatal maternal screening for current mental health: evaluation of a change in the use of the Edinburgh Depression Scale in clinical practice.

A hospital antenatal clinic conducting routine psychosocial screening changed the Edinburgh Depression Scale (EDS) referral criterion for determining which women needed to be referred to a multidisciplinary meeting health professional ("Safe Start meeting"). The criterion was changed from a score of 10 or more to 13 or more, when no other psychosocial risks were present. Women scoring 10-12 on the EDS, with no other psychosocial risks, were now informed they should contact the Social Work Department if they had issues they wanted to discuss with a health professional.

Maternal mental health in Australia and New Zealand: a review of longitudinal studies.

Aim: The aim of this paper is to describe the factors that impact on the mental health of Australian and New Zealand (NZ) women in the perinatal period (pregnancy and the year following birth), and to determine the impact of perinatal mental health on women's subsequent health by summarising findings from prospective longitudinal studies conducted in Australia and NZ.

Methods: A systematic search was conducted using the databases, Scopus, Medline, PsychInfo and Health Source to identify prospective longitudinal studies focused on women's social and emotional health in the perinatal period. Forty-eight papers from eight longitudinal studies were included.