ABSTRACT
Despite the prevalence of postpartum depression and anxiety, current screening recommendations are limited to depression symptoms. Screening using the Edinburgh Postnatal Depression Scale-Anxiety subscale (EPDS-A) may enhance ability to detect distress in postpartum women. We aimed to replicate the EPDS-A in 200 mothers with infants hospitalized in the neonatal intensive care unit (NICU) and examine its incremental utility in identifying emotional distress. Presence of the EPDS-A was identified using exploratory factor analysis. Women experiencing elevated anxiety were identified using a previously established cutoff score. Results replicated the EPDS-A for the first time in mothers with infants hospitalized in the NICU. In all, 21.9% of these women had elevated anxiety symptoms and nearly one quarter of them would have been missed in routine depression screening. Use of the EPDS-A, in addition to the total EPDS score, is a promising approach to identifying anxious women in need of further evaluation, treatment, or support.
Subject(s)
Anxiety/diagnosis , Mass Screening , Mothers/psychology , Psychiatric Status Rating Scales/statistics & numerical data , Adult , Anxiety/epidemiology , Anxiety/psychology , Depression/diagnosis , Female , Humans , Intensive Care Units, Neonatal , Midwestern United States/epidemiology , Prevalence , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To examine the incremental identification of emotional distress in mothers of hospitalized newborns by screening for anxiety in addition to depression and to provide practical information about anxiety screening scales to facilitate instrument selection and screening implementation by nurses in the NICU. DESIGN: In this secondary data analysis, screening data from the recruitment phase of a feasibility trial to evaluate a nurse-delivered counseling intervention for emotionally distressed mothers of newborns in the NICU were used to examine the effect of anxiety screening. SETTING: A Level IV NICU at a large academic medical center in the Midwestern United States. PARTICIPANTS: Women 18 years of age and older (N = 190) with newborns in the NICU. METHODS: Participants completed multiple measures of depression and anxiety symptoms. RESULTS: Of participants who had negative screening results on a depression-only screening instrument, 4.7% to 14.7% endorsed clinically significant anxiety symptoms depending on the screening instrument used. CONCLUSION: Screening for anxiety in mothers of newborns in the NICU resulted in identification of distressed mothers who would otherwise have been missed during routine depression-only screening. Multiple options for anxiety screening exist that add incremental information to depression-only screening and require little additional burden on providers and mothers of newborns in the NICU.
Subject(s)
Child, Hospitalized , Depression, Postpartum/therapy , Intensive Care, Neonatal/psychology , Mass Screening/methods , Mothers/psychology , Academic Medical Centers , Adult , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Anxiety Disorders/therapy , Counseling/methods , Depression, Postpartum/diagnosis , Feasibility Studies , Female , Humans , Infant, Newborn , Midwestern United States , Risk Assessment , Stress, Psychological , Treatment OutcomeABSTRACT
Disaster exposure during pregnancy has received limited attention. This study examined the impact of the 2008 Iowa Floods on perinatal maternal depression and well-being, and the role of peritraumatic distress as a possible mechanism explaining this link. Perinatal women (N = 171) completed measures of depressive symptoms and general well-being at 5 timepoints from pregnancy to 30 months postpartum. Objectively assessed prenatal flood exposure was associated with greater depression (r = .15). Further, flood-related peritraumatic distress was uniquely associated with greater depression (r = .23), and was a key mechanism through which flood exposure led to depression. Prenatal flood exposure was also associated with general well-being (r = .18); however, a mechanism other than peritraumatic distress appears to have been responsible for the effect of flood exposure on well-being. We discuss the implications of these findings for informing etiological models and enhancing the efficacy of interventions for maternal psychopathology.
