Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Oct 8;2008(4):CD005124.
doi: 10.1002/14651858.CD005124.pub2.

Antenatal psychosocial assessment for reducing perinatal mental health morbidity

Marie-Paule Austin  1 , Susan R Priest, Elizabeth A Sullivan
Affiliations

Antenatal psychosocial assessment for reducing perinatal mental health morbidity

Marie-Paule Austin et al. Cochrane Database Syst Rev. .

Abstract

Background: Mental health conditions arising in the perinatal period, including depression, have the potential to impact negatively on not only the woman but also her partner, infant, and family. The capacity for routine, universal antenatal psychosocial assessment, and thus the potential for reduction of morbidity, is very significant.

Objectives: To evaluate the impact of antenatal psychosocial assessment on perinatal mental health morbidity.

Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, the Cochrane Depression, Anxiety and Neurosis Group's Trials Register (CCDAN TR-Studies), HSRProj in the National Library of Medicine (USA), and the Current Controlled Trials website: http://www.controlled trials.com/ and the UK National Research Register (last searched March 2008).

Selection criteria: Randomised and quasi-randomised controlled trials.

Data collection and analysis: At least two review authors independently assessed trials for eligibility; they also extracted data from included trials and assessed the trials for potential bias.

Main results: Two trials met criteria for an RCT of antenatal psychosocial assessment. One trial examined the impact of an antenatal tool (ALPHA) on clinician awareness of psychosocial risk, and the capacity of the antenatal ALPHA to predict women with elevated postnatal Edinburgh Depression Scale (EDS) scores, finding a trend towards increased clinician awareness of 'high level' psychosocial risk where the ALPHA intervention had been used (relative risk (RR) 4.61 95% confidence interval (CI) 0.99 to 21.39). No differences between groups were seen for numbers of women with antenatal EDS scores, a score of greater than 9 being identified by ALPHA as of concern for depression (RR 0.69 95% CI 0.35 to 1.38); 139 providers. The other trial reported no differences in EPS scores greater than 12 at 16 weeks postpartum between the intervention (communication about the EDS scores with the woman and her healthcare providers plus a patient information booklet) and the standard care groups (RR 0.86 95% CI 0.61 to 1.21; 371 women).

Authors' conclusions: While the use of an antenatal psychosocial assessment may increase the clinician's awareness of psychosocial risk, neither of these small studies provides sufficient evidence that routine antenatal psychosocial assessment by itself leads to improved perinatal mental health outcomes. Further studies with better sample size and statistical power are required to further explore this important public health issue. It will also be important to examine outcomes up to one year postpartum not only for mother, but also infant and family.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 IDEA versus standard care, Outcome 1 EPDS > 12 (at 16 weeks postpartum).
2.1
2.1. Analysis
Comparison 2 ALPHA versus standard care, Outcome 1 High level of provider concern (adj for cluster).
2.2
2.2. Analysis
Comparison 2 ALPHA versus standard care, Outcome 2 At least one psychosocial concern identified (adj for cluster).
2.3
2.3. Analysis
Comparison 2 ALPHA versus standard care, Outcome 3 At least one concern identified in at least one woman (by provider).
2.4
2.4. Analysis
Comparison 2 ALPHA versus standard care, Outcome 4 Women identified with a risk factor (adj for cluster).
2.5
2.5. Analysis
Comparison 2 ALPHA versus standard care, Outcome 5 Failure to identify EPDS > 9 antenatally.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD005124

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Carroll 2005 {published data only}
    1. Blackmore ER, Carroll J, Reid A, Biringer A, Glazier RH, Midmer D, et al. The use of the antenatal psychosocial health assessment (ALPHA) tool in the detection of psychosocial risk factors. Journal of Obstetrics and Gynaecology Canada 2006;28:873‐8. - PubMed
    1. Carroll JC, Reid AJ, Biringer A, Midmer D, Glazier RH, Wilson L, et al. Effectiveness of the Antenatal Psychosocial Health Assessment (ALPHA) form in detecting psychosocial concerns: a randomised controlled trial. Canadian Medical Association Journal 2005;173(3):253‐9. - PMC - PubMed
Webster 2003a {published data only}
    1. Webster J, Linnane J, Roberst J, Starrenburg S, Hinson J, Dibley L. IDentify, Educate and Alert (IDEA) trial: an intervention to reduce postnatal depression. British Journal of Obstetrics and Gynaecology 2003;110:842‐6. - PubMed

References to studies excluded from this review

Appleby 1994 {published data only}
    1. Appleby L, Gregoire A, Platz C, Prince M, Kumar R. Screening women for high risk of postnatal depression. Journal of Psychosomatic Research 1994;38:539‐45. - PubMed
Areias 1996 {published data only}
    1. Areias MEG, Kumar R, Barros H, Figueiredo E. Correlates of depression in mothers and fathers. British Journal of Psychiatry 1996;169:36‐41. - PubMed
Austin 2005a {published data only}
    1. Austin MP, Hadzi‐Pavlovic D, Leader L, Saint K, Parker G. Antenatal screening for the prediction of postnatal depression: validation of a psychosocial pregnancy risk questionnaire. Acta Psychiatrica Scandinavica 2005;112:310‐7. - PubMed
Austin 2008 {published data only}
    1. Austin MP, Frilingos M, Lumley J, Hadzi‐Pavlovic D, Roncolato W, Acland S, et al. Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial. Journal of Affective Disorders 2008;105(1‐3):35‐44. - PubMed
Brugha 2000 {published data only}
    1. Brugha TS, Wheatley S, Taub NA, Culverwell A, Friedman T, Kirwan P, et al. Pragmatic randomised trial of antenatal intervention to prevent postnatal depression by reducing psychosocial risk factors. Psychological Medicine 2000;30:1273‐81. - PubMed
Buist 1999 {published data only}
    1. Buist A, Westley D, Hill C. Antenatal prevention of postnatal depression. Archives of Women's Mental Health 1999;1(4):167‐73.
Cooper 1996a {published data only}
    1. Cooper PJ, Murray L, Hooper R, West A. The development and validation of a predictive index for postpartum depression. Psychological Medicine 1996;36:627‐34. - PubMed
Fergerson 2002 {published data only}
    1. Fergerson SS, Jamieson DJ, Lindsay M. Diagnosing postpartum depression: can we do better?. American Journal of Obstetrics and Gynecology 2002;186:899‐902. - PubMed
Forman 1998 {published data only}
    1. Forman DN, Videbech P, Hedegaard M, Salvig JD, Secher NJ. Postpartum depression: identification of women at risk. British Journal of Obstetrics and Gynaecology 2000;107:1210‐7. - PubMed
Glasser 1998 {published data only}
    1. Glasser S, Barell V, Shoham A, Ziv A, Boyko V, Lusky A, et al. Prospective study of postpartum depression in an Israeli cohort: prevalence, incidence and demographic risk factors. Journal of Psychosomatic Obstetrics and Gynecology 1998;19:155‐64. - PubMed
Green 1994 {published data only}
    1. Green JM, Murray D. The use of the Edinburgh Postnatal Depression Scale in research to explore the relationship between antenatal and postnatal dysphoria. In: Cox J, Holden J editor(s). Perinatal psychiatry. London: Gaskell, 1994:180‐98.
Hobfoil 1995 {published data only}
    1. Hobfoil SE, Ritter C, Lavin J, Hulsizer MR. Depression prevalence and incidence among inner‐city pregnant and postpartum women. Journal of Consulting and Clinical Psychology 1995;63:445‐53. - PubMed
Honey 2003 {published data only}
    1. Honey KL, Bennett P, Morgan M. Predicting postnatal depression. Journal of Affective Disorders 2003;76:201‐10. - PubMed
Johanson 2000 {published data only}
    1. Johanson R, Chapman G, Murray D, Johnson I, Cox J. The North Staffordshire Maternity Hospital prospective study of pregnancy‐associated depression. Journal of Psychosomatic Obstetrics and Gynecology 2000;21:93‐7. - PubMed
Josefsson 2001 {published data only}
    1. Josefsson A, Berg G, Nordin C, Sydsjo G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstetricia et Gynecologica Scandinavica 2001;80:251‐5. - PubMed
Leverton 1989 {published data only}
    1. Leverton TJ, Elliott SA. Transition to parenthood groups: a preventive intervention for perinatal depression?. In: Hall EV, Everard W editor(s). The free woman: women's health in the 1990s. Invited papers of the 9th international conference of psychosomatic obstetrics and gynecology. Lancaster: Parthenon Press, 1989:479‐86.
Midmer 2004 {published data only}
    1. Midmer D, Bryanton J, Brown R. Assessing antenatal psychosocial health, Randomized controlled trial of two versions of the alpha form. Canadian Family Physician 2004;50:80‐7. - PMC - PubMed
Posner 1997 {published data only}
    1. Posner NA, Unterman RR, Williams KN, Williams GH. Screening for postpartum depression: an antepartum questionnaire. Journal of Reproductive Medicine 1997;42:207‐15. - PubMed
Stamp 1996 {published data only}
    1. Stamp GE, Williams AS, Crowther CA. Predicting postnatal depression among pregnant women. Birth 1996;23:218‐23. - PubMed
Webster 2000 {published data only}
    1. Webster J, Linnane JWJ, Dibley LM, Pritchard M. Improving antenatal recognition of women at risk for postnatal depression. Australian and New Zealand Journal of Obstetrics and Gynaecology 2000;10:409‐12. - PubMed
Webster 2003b {published data only}
    1. Webster J, Pritchard MA, Creedy D, East C. A simplified predictive index for the detection of women at risk for postnatal depression. Birth 2003;30:101‐8. - PubMed
Webster 2006 {published data only}
    1. Webster J, Hall L, Somville T, Schneider P, Turnbull R, Smith P. Prospective testing of the Brisbane Postnatal Depression Index. Birth 2006;33:56‐63. - PubMed
Zlotnick 2001 {published data only}
    1. Zlotnick C, Johnson SL, Miller I, Pearlstein T, Howard M. Postpartum depression in women receiving public assistance: pilot study of an inter‐personal‐therapy oriented group program. American Journal of Psychiatry 2001;158:638‐40. - PubMed

Additional references

APA 1994
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington: American Psychiatric Association, 1994.
Appleby 1997
    1. Appleby L, Warner R, Whitton A, Faragher BA. A controlled study of fluoxetine and cognitive‐behavioural counselling in the treatment of postnatal depression. BMJ 1997;314:932‐6. - PMC - PubMed
Atkinson 1997
    1. Atkinson L, Zucker KJ. Attachment and psychopathology. NY: Guilford Press, 1997.
Austin 2000
    1. Austin MP, Leader L. Maternal stress and obstetric and infant outcomes: epidemiological findings and neuroendocrine mechanisms. Australian and New Zealand Journal of Obstetrics and Gynaecology 2000;40:331‐7. - PubMed
Austin 2003a
    1. Austin MP, Lumley J. Antenatal screening for postnatal depression: a systematic review. Acta Psychiatrica Scandinavica 2003;107(1):10‐7. - PubMed
Austin 2003b
    1. Austin MP. Psychosocial assessment and management of depression and anxiety in pregnancy. Australian Family Physician 2003;32(3):119‐26. - PubMed
Austin 2003c
    1. Austin MP. Targeted group antenatal prevention of postnatal depression: a review. Acta Psychiatrica Scandinavica. 2003;107(4):244‐50. - PubMed
Austin 2005
    1. Austin M‐P, Hadzi‐Pavlovic D, Leader L, Saint K, Parker G. Antenatal screening for the prediction of postnatal depression: validation of a psychosocial pregnancy risk questionnaire. Acta Psychiatrica Scandinavica 2005;112:310‐7. - PubMed
Austin 2007
    1. Austin M‐P, Kildea S, Sullivan E. Perinatal maternal mortality and psychiatric morbidity: challenges and opportunities for prevention in the Australian setting. Medical Journal of Australia 2007;186(7):364‐7. - PubMed
Bacchus 2004
    1. Bacchus L, Mezey G, Bewley S. Domestic violence: prevalence in pregnant women and associations with physical and psychological health. European Journal of Obstetrics & Gynecology and Reproductive Biology 2004;113(1):6‐11. - PubMed
Barlow 2003
    1. Barlow J, Coren E. Parent‐training programmes for improving maternal psychosocial health. The Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD002020.pub2. DOI: 10.1002/14651858.CD002020.pub2. - PubMed
Barnett 1993
    1. Barnett B, Lockhart K, Bernard D, Maricavasagar V, Dudley M. Mood disorders among infants of mothers admitted to a mothercraft hospital. Journal of Paediatrics and Child Health 1993;29:270‐5. - PubMed
Barnett 2005
    1. Barnett B, Glossop P, Matthey S, Stewart H. Screening in the context of Integrated Perinatal Care. In: Henshaw C, Elliott S editor(s). Screening for Perinatal Depression. London: Jessica Kingsley, 2005.
Beck 1961
    1. Beck AT, Ward CH, Mendelson M. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561‐71. - PubMed
Blackmore 2006
    1. Blackmore ER, Carroll J, Reid A, Biringer A, Glazier RH, Midmer D, et al. The use of the antenatal psychosocial health assessment (ALPHA) tool in the detection of psychosocial risk factors. Journal of Obstetrics and Gynaecology Canada 2006;28:873‐8. - PubMed
Boyce 1994
    1. Boyce P. Personality dysfunction, marital problems, and postnatal depression. In: Cox J, Holden J editor(s). Use and misuse of the Edinburgh Postnatal Depression Scale. London: Gaskell, 1994.
Brockington 2004
    1. Brockington I. Postpartum psychiatric disorders. Lancet 2004;363:303‐10. - PubMed
Buist 2002
    1. Buist AE, Barnett BE, Milgrom J, Pope S, Condon JT, Ellwood D, et al. To screen or not to screen‐‐that is the question in perinatal depression. Medical Journal of Australia 2002;177 Suppl:S101‐5. - PubMed
Buist 2006
    1. Buist A, Condon J, Brooks J, Speelman C, Milgrom J, Hayes B, et al. Acceptability of routine screening for postnatal depression. Journal of Affective Disorders 2006;93:233‐7. - PubMed
Campbell 1995
    1. Campbell S, Cohn J, Meyers T. Depression in first‐time mothers: mother‐infant interaction, and depression chronicity. Developmental Psychology 1995;31:349‐57.
Carter 2003
    1. Carter AS, Garrity‐Roukas FE, Chazan‐Cohen R, Little C, Broggs‐Gowan M. Maternal depression and co‐morbidity: predicting early parenting, attachment security and toddler social‐emotional problems and competencies. Journal of the American Academy of Child and Adolescent Psychiatry 2003;40:18‐26. - PubMed
Civic 1993
    1. Civic D, Holt VL. Maternal depressive symptoms and child behaviour problems in a nationally representative normal birthweight sample. Maternal and Child Health 1993;29:270‐5. - PubMed
Cooper 1995
    1. Cooper PJ, Murray L. Course and recurrence of postnatal depression: evidence for the specificity of the diagnostic concept. British Journal of Psychiatry 1995;166:191‐5. - PubMed
Cooper 2003
    1. Cooper PJ, Murray L, Wilson A, Romaniuk H. Controlled trial of the short‐ and long‐term effect of psychological treatment of postpartum depression. Impact on maternal mood. British Journal of Psychiatry 2003;182:412‐9. - PubMed
Cox 1987
    1. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. British Journal of Psychiatry 1987;150:782‐6. - PubMed
Cox 1993
    1. Cox J, Murray D, Chapman G. A controlled study of the onset, duration and prevalence of postnatal depression. British Journal of Psychiatry 1993;163:27‐31. - PubMed
Dennis 1999
    1. Dennis CL, Ross LE, Herxheimer A. Oestrogens and progestins for preventing and treating postpartum depression. Cochrane Database of Systematic Reviews 1999, Issue 3. - PMC - PubMed
Dennis 2004
    1. Dennis C‐L, Creedy D. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database of Systematic Reviews 2004, Issue 4. [Art. No.: CD001134. DOI: 10.1002/14651858.CD001134.pub2] - PubMed
Doggett 2005
    1. Doggett C, Burrett S, Osborn DA. Home visits during pregnancy and after birth for women with an alcohol or drug problem. Cochrane Database of Systematic Reviews 2005, Issue 4. [Art. No.: CD004456. DOI: 10.1002/14651858.CD004456.pub2] - PubMed
Elliot 2000
    1. Elliot SA, Leverton TJ, Sanjack M, Turner H, Cowmeadow P, Hopkins J, et al. Promoting mental health after childbirth: a controlled trial of primary prevention of postnatal depression. British Journal of Clinical Psychology 2000;39:223‐1. - PubMed
Endicott 1978
    1. Endicott J, Spitzer R. A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 1978;35:837‐44. - PubMed
Fergusson 1996
    1. Fergusson DM, Horwood LJ, Thorpe K. Changes in depression during and following pregnancy. ALSPAC Study Team. Study of pregnancy and children. Perinatal Epidemiology 1996;10:279‐93. - PubMed
Gavin 2005
    1. Gavin NI, Gaynes BN, Lohr KN, Meltzer‐Brody S, Gatrlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstetrics and Gynecology 2005;106:1071‐83. - PubMed
Glover 2002
    1. Glover V, O'Connor TG. Effects of antenatal stress and anxiety. British Journal of Psychiatry 2002;180:389‐91. - PubMed
Gotzsche 2006
    1. Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database of Systematic Reviews 2006, Issue 4. [Art. No.: CD001877. DOI: 10.1002/14651858.CD001877.pub2] - PubMed
Heron 2004
    1. Heron J, O'Connor TG, Evans J, Golding J, Glover V. The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders 2004;80:65‐73. - PubMed
Higgins 2008
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008.
Hoffbrand 2001
    1. Hoffbrand S, Howard L, Crawley H. Antidepressant treatment for post‐natal depression. Cochrane Database of Systematic Reviews 2001, Issue 2. [Art. No.: CD002018. DOI: 10.1002/14651858.CD002018] - PubMed
Howard 2005
    1. Howard LM, Hoffbrand S, Henshaw C, Boath L, Bradley E. Antidepressant prevention of postnatal depression. Cochrane Database of Systematic Reviews 2005, Issue 2. [Art. No.: CD004363. DOI: 10.1002/14651858.CD004363.pub2] - PubMed
Huizink 2002
    1. Huizink AC, Robles De Medina PG, Mulder EJH, Visser GHA. Psychological measures of prenatal stress as predictors of infant temperament. Journal of the American Academy of Child and Adolescent Psychiatry 2002;41(9):1078‐85. - PubMed
Lumley 2004
    1. Lumley J, Austin MP, Mitchell C. Intervening to reduce depression after birth: a systematic review of the randomized trials. International Journal of Technology and Assessment in Health Care 2004;20(2):128‐44. - PubMed
Matthey 2003
    1. Matthey S, Barnett B, Howie P, Kavanagh DJ. Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety?. Journal of Affective Disorders 2003;74:139‐47. - PubMed
Matthey 2004
    1. Matthey S. Detection and treatment of postnatal depression or anxiety. Current Opinion in Psychiatry 2004;17(1):21‐9.
McNair 1971
    1. McNair DM, Lorr M, Droppleman LF. Profile of mood states. San Diego, CA: Educational and Industrial Testing Service, 1977.
Mietinnen 2003
    1. Miettinnen OS, Yankelevitz DF, Henschke CI. Evaluation of screening for a cancer: annotated catechism of the Gold Standard creed. Journal of Evaluation of Clinical Practice 2003;9:145‐50. - PubMed
Misri 2000
    1. Misri S, Kostaras X, Fox D, Kostaras D. The impact of partner support in the treatment of postpartum depression. Canadian Journal of Psychiatry 2000;45:554‐8. - PubMed
Murray 1990
    1. Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh Postnatal Depression Scale. Journal of Reproductive and Infant Psychology 1990;8:99‐107.
Murray 1997
    1. Murray L, Cooper P. Postpartum depression and child development. Psychological Medicine 1997;27:253‐60. - PubMed
Murray 2003
    1. Murray L, Woolgar M, Murray J, Cooper P. Self‐exclusion from health care in women at high risk for postpartum depression. Journal of Public Health Medicine 2003;25(2):131‐7. - PubMed
Murray 2004
    1. Murray L, Cooper PJ. The impact of postnatal depression on child development. In: Goodyer I editor(s). Aetiological mechanisms in developmental psychopathology. Oxford: Oxford University Press, 2004.
NICE 2007
    1. National Institute of Clinical Excellence (UK). Antenatal and postnatal mental health: clinical management and service guidance. http:www.nice.org.uk/CG45 2007. - PubMed
NSC 1998
    1. National Screening Committee. Health Departments of the United Kingdom. Criteria for appraising the viability,effectiveness and appropriateness of a screening programme. In: First Report of the National Screening Committee. Oxford: Health Departments of the United Kingdom, 1998.
NSC 2003
    1. National Electronic Library for Screening. Depression: National Screening Committee Policy Position. http://www.nelh.nhs.uk/screening/adult_pps/depression.html (accessed March 2003).
O'Connor 2002
    1. O'Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years: report from the ALSPAC. British Journal of Psychiatry 2002;180:502‐8. - PubMed
O'Hara 1997
    1. O'Hara M. The nature of postpartum depressive disorders. In: Murray L, Cooper P editor(s). Postpartum depression and child development. New York: Guilford, 1997.
O'Hara 2004
    1. O'Hara MW, Gorman LL. Can postpartum depression be predicted?. Primary Psychiatry 2004;11(3):42‐7.
Oates 2003
    1. Oates M. Perinatal psychiatric disorders: a leading cause of maternal morbidity and mortality. British Medical Bulletin 2003;67:219‐29. - PubMed
Ogrodniczuk 2003
    1. Ogrodniczuk JS, Piper WE. Preventing postnatal depression: a review of research findings. Harvard Review of Psychiatry 2003;11(6):291‐307. - PubMed
Patel 2004
    1. Patel V, Rahman A, Jacob KS, Hughes M. Effect of maternal health on infant growth in low income countries: new evidence from South Asia. BMJ 2004;328:820‐3. - PMC - PubMed
Preisig 2001
    1. Preisig M, Merikangas KR, Angst J. Clinical significance and comorbidity of subthreshold depression and anxiety in the community. Acta Psychiatrica Scandinavica 2001;104:96‐103. - PubMed
Priest 2003
    1. Priest SR, Henderson J, Evans SF, Hagan R. Stress debriefing after childbirth: a randomised controlled trial. Medical Journal of Australia 2003;178:542‐5. - PubMed
Radloff 1977
    1. Radloff LS. The CES‐D Scale: a self‐report depression scale for research in the general population. Applied Psychological Measurement 1977;1:385‐401.
RevMan 2008 [Computer program]
    1. The Nordic Cochrane Centre. Review Manager (RevMan). Version 5.0 for Windows. Copenhagen: The Nordic Cochrane Centre, 2008.
Robins 1981
    1. Robins LN, Helzer JE, Croughan J. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Archives of General Psychiatry 1981;38:381‐91. - PubMed
Shakespeare 2001
    1. Shakespeare J. Evaluation of screening for postnatal depression against the NSC handbook criteria. http://www.nelh.nhs.uk/screening/adult_pps/Shakespeare_final paper.pdf (accessed June 2001).
Sheehan 1998
    1. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini‐International Neuropsychiatric Interview (M.I.N.I): the development and validation of a structured diagnostic psychiatric interview for DSM‐IV and ICD‐10. Journal of Clinical Psychiatry 1998;59 Suppl 20:22‐33. - PubMed
Spielberger 1970
    1. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State‐Trait Anxiety Inventory (Self evaluation questionnaire). Palo Alto, CA: Consulting Psychologists Press, 1970.
Stuart 1998
    1. Stuart S, Couser G, Schilder K, O'Hara M, Gorman L. Postpartum anxiety and depression: onset and comorbidity in a community sample. Journal of Nervous and Mental Disorders 1998;186:420‐4. - PubMed
Verkerk 2003
    1. Verkerk GJM, Pop VJM, Son MJM, Heck GL. Prediction of depression in the postpartum period: a longitudinal follow‐up study in high‐risk and low‐risk women. Journal of Affective Disorders 2003;77:159‐66. - PubMed

Publication types

MeSH terms