Mental health disorders among pregnant women can be screened just as effectively by using a two-question tool as with a 10-point questionnaire, a new UK study has found.
The research, carried out by academics at King’s College London, also found that 25% of pregnant women have a mental health illness – a higher proportion than had previously been thought.
“It is encouraging that…there was little difference in diagnostic accuracy between the commonly used tools”
It is the first UK study to examine the prevalence of mental health problems or mental disorders when seen by a midwife for pregnancy care.
Researchers compared the use of the two-question Whooley tool with the longer Edinburgh Postnatal Depression Scale among 545 pregnant women attending an antenatal appointment at a maternity service in South East London.
The study, carried out between November 2014 and June 2016, revealed there was “little difference” in the ability of the two tools to identify whether a woman had “any disorder”, according to those behind the research.
In addition, from interviewing the women, the researchers said they found one in four had a mental illness.
While 11% had depression, and 15% had anxiety problems, the interviews also revealed 2% had eating disorders, 2% had obsessive-compulsive disorder, 1% had post-traumatic stress disorder. Other disorders, such as bipolar, were also found, but less commonly.
“Maternity professionals need to identify whether or not a woman has any mental disorder, not only mood disorders”
There was also evidence that identification of depression was more difficult in older women than younger women.
Mental illness during pregnancy is associated with adverse outcomes for women, the pregnancy itself, and for the child, highlighted the researchers. They noted it was vital these disorders were diagnosed as early as possible.
Louise Howard, professor of women’s mental health, at King’s College London, authored the report, which was published this week in the British Journal of Psychiatry.
“In clinical practice, maternity professionals need to identify whether or not a woman has any mental disorder, not only mood disorders, which until recently have been the main focus of concern,” she said.
“It is therefore encouraging that, in this study, there was little difference in diagnostic accuracy between the commonly used tools – the Whooley questions and the EPDS – in identifying a mental disorder,” said Professor Howard.
“This study supports the NICE recommendation that women should be asked, by a non-judgemental and supportive health professional, at all contacts in pregnancy and after birth about their emotional wellbeing and are given the opportunity to respond to these structured questions (the Whooley or the EPDS),” she said.
“A positive identification then needs to be followed by a clinical assessment by an appropriate health practitioner to establish the clinical diagnosis and appropriate intervention,” she added.