Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care
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Perinatal depression currently receives considerable attention, but not all perinatal women presenting for psychiatric care are depressed. The Edinburgh Postnatal Depression Scale (EPDS) is now routinely administered, but high scores are interpreted as evidence for depressive illness only. This study examined psychiatric diagnoses and mean EPDS scores among perinatal women at a tertiary center. Women accessing care between March 2006 and June 2008 completed a clinical diagnostic interview and the EPDS. Mean EPDS scores were calculated for each psychiatric diagnosis; sensitivity and specificity were calculated for major depressive episode (MDE) and generalized anxiety disorder (GAD). The majority of the sample (N = 91), 49.5%, had GAD comorbid with MDE or another anxiety disorder, followed by MDE (38.5%) comorbid with an anxiety disorder. One third (29.7%) met criteria for MDE and GAD. Only 3.3% had MDE alone and 5.5% had GAD alone. Half the sample (50.5%) had more than one psychiatric disorder. Mean EPDS scores exceeded 11 for the majority of diagnostic groups. Sensitivity of the EPDS for MDE was 0.78 and 0.70 for GAD. Most women had an anxiety disorder and met criteria for more than one psychiatric disorder. Mean EPDS scores were consistently high. Sensitivity of the EPDS for MDE and GAD was comparable.
KeywordsPregnancy Postpartum Depression Anxiety Screening
Funding, support, and acknowledgments
The authors would like to thank Women’s College Hospital for internal funding to support this project, Drs. Svetlana Emilianova and Jasmine Gandhi for their assistance with recruitment, Tasha Schumann and Laura Orlando for assisting with various phases of the work, and all the patients who contributed their time to this project at a very difficult time in their lives.
Dr. Grigoriadis has a New Investigator Award in Women's Health Research from the Canadian Institutes of Health Research (CIHR, NOW-182838) in partnership with the Ontario Women's Health Council. Dr. L. Ross is supported by a New Investigator Award from CIHR and the Ontario Women’s Health Council, Award NOW-84656. In addition, support to CAMH for salary of scientists and infrastructure has been provided by the Ontario Ministry of Health and Long-Term Care. The views expressed here do not necessarily reflect those of the Ministry of Health and Long-Term Care.
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