Thandi van Heyningen|Simone Honikman|Mark Tomlinson|Sally Field|Landon Myer
Comparison of mental health screening tools for detecting antenatal depression and anxiety disorders in South African women
University of Cape Town|University of Cape Town|University of the Witwatersrand|Stellenbosch University|University of Cape Town|University of Cape Town
antenatal depression anxiety disorders highly prevalent low middleincome countries screening pregnant women primary care antenatal settings provides opportunity entry care data needed performance different screening tools compared five widelyused questionnaires sample pregnant women urban south africapregnant women attending primary care antenatal clinic administered five tools trained research assistants edinburgh postnatal depression scale epds patient health questionnaire phq9 kessler psychological distress scale k10 shortened 6item version k6 whooley questions twoitem generalised anxiety disorder scale gad2 following registered mental health counsellor administered mini plus structured clinical diagnostic interview area curve auc receiver operator characteristic curve analysis used summarise screening test performance cronbachs used assess internal consistencyof 376 participants 32 diagnosed either mde andor anxiety disorders five questionnaires demonstrated moderate high performance auc 078085 epds best performing instrument detecting mde k10 k6 anxiety disorder mde andor anxiety disorders epds highest auc 083 short instruments k10 auc 085 k6 auc 085 performed best k6 showing good balance sensitivity 74 specificity 85 good positive predictive value 70 whooley questions auc 081 best performing ultrashort instrument internal consistency ranged good acceptable 089071 however ppv questionnaires compared diagnostic interview ranged 54 71 optimal cutoff scoresuniversal screening case identification antenatal depression anxiety disorders lowresource settings conducted number commonly used screening instruments short ultrashort screening instruments k6 whooley questions may feasible acceptable use settings