The development of an ultra-short, maternal mental health screening tool in South Africa.

Journal: Global mental health (Cambridge, England)

Volume: 6

Issue: 

Year of Publication: 

Affiliated Institutions:  Perinatal Mental Health Project, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa.

Abstract summary 

The burden of common perinatal mental disorders (CPMD) in low-and-middle-income countries is substantially higher than high-income countries, with low levels of detection, service provision and treatment in resource-constrained settings. We describe the development of an ultra-short screening tool to detect antenatal depression, anxiety disorders and maternal suicidal ideation.A sample of 376 women was recruited at a primary-level obstetric clinic. Five depression and anxiety symptom-screening questionnaires, demographics and psychosocial risk questionnaires were administered. All participants were assessed with the Mini-International Neuropsychiatric Interview (MINI), a structured, diagnostic interview. Screening tool items were analysed against diagnostic data using multiple logistic regression and receiver operating curve (ROC) analysis.The prevalence of MINI-defined major depressive episode (MDE) and/or anxiety disorders was 33%. Overall, 18% of participants expressed suicidal ideation and behaviour, 54% of these had no depression or anxiety diagnosis. Multiple logistic regression identified four screening items that were independently predictive of MDE and anxiety disorders, investigating depressed mood, anhedonia, anxiety symptoms and suicidal ideation. ROC analysis of these combined items yielded an area under the curve of 0.83 (95% CI 0.78-0.88). A cut-off score of 2 or more offered a sensitivity of 78% and specificity of 82%.This novel screening tool is the first measure of CPMD developed in South Africa to include depressed mood, anxiety symptoms and suicidal ideation. While the tool requires further investigation, it may be useful for the early identification of mental health symptoms and morbidity in the perinatal period.

Authors & Co-authors:  van Heyningen T T Myer L L Tomlinson M M Field S S Honikman S S

Study Outcome 

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Statistics
Citations :  Afulani PA, Diamond-Smith N, Golub G, Sudhinaraset M (2017). Development of a tool to measure person-centered maternity care in developing settings: validation in a rural and urban Kenyan population. Reproductive Health 14, 1–18.
Authors :  5
Identifiers
Doi : e24
SSN : 2054-4251
Study Population
Women
Mesh Terms
Other Terms
Antenatal screening;common perinatal mental disorders;low- and middle-income countries;ultra-short
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England