Validity and utility of instruments for screening of depression in women attending antenatal clinics in Blantyre district in Malawi

Chorwe‐Sungani, Genesis; Chipps, Jennifer

doi:10.1080/20786190.2018.1432136

Cited by 9 publications

(10 citation statements)

References 34 publications

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“…Midwives will initially administer the 3-Item Screener [ 15 , 17 ] to pregnant women during history taking (Additional file 3 ) and those who will screen positive on the 3-Item Screener will be interviewed further using Self Reporting Questionnaire (SRQ) 20 (Additional file 3 ) immediately [ 15 , 17 ]. Pregnant women who will screen positive on SRQ 20 will be further interviewed by the PI or a mental health nurse to confirm the presence of major depressive episode on the same day using the major depression module of the Mini International Neuropsychiatric Interview (MINI) [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

“…The American College of Obstetricians and Gynaecologists recommended that pregnant women should be screened for antenatal depression using a standardised and validated instrument [ 14 ]. Screening for depression in antenatal clinics can be done in stages whereby various instruments are combined [ 15 ]. Screening in stages may involve a two-step process where a short screening instrument is used to identify potential cases and, for those who screen positive, a second, often more detailed instrument with greater specificity, is used to confirm the diagnosis [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…The SPADe recommends the use of a two-step process whereby the 3-item screener (ultra-brief instrument) should initially be used by midwives to identify potential depression cases followed by Self Reporting Questionnaire (SRQ) 20 to confirm the cases and later a gold standard administered by a mental health specialist to confirm a diagnosis [ 15 ]. This is supported by Whooley [ 18 ] who asserted that any positive screen result on an ultra-brief instrument must be followed by a clinical interview to confirm the presence of depression.…”

Section: Introductionmentioning

confidence: 99%

“…As such, antenatal care visits provide critically important opportunities for mental health interventions to occur. But antenatal depression is often underdiagnosed by midwives because there are no depression screening instruments at antenatal clinics in Malawi [ 15 ]. Nonetheless, a previous study proposed SPADe, a locally developed protocol as suitable for screening depression among pregnant women in antenatal clinics in Blantyre District [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Antenatal depression is often underdiagnosed by midwives because there are no depression screening instruments at antenatal clinics in Blantyre District in Malawi [ 15 ]. In this study, an implementation strategy for screening antenatal depression (SPADe) by midwives will be tested in three antenatal clinics in Blantyre District [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

Chorwe‐Sungani

Mwagomba

Kulisewa

et al. 2021

Pilot Feasibility Stud

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Background Depression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District. SPADe proposes multistage screening of antenatal depression by midwives which may enable early detection and treatment of pregnant women with depression. Proper treatment of antenatal depression can assist in achieving Sustainable Development Goals (SDGs). However, utilisation of SPADe in clinical practice to screening for depression in antenatal clinics has not been established yet. Therefore, the primary aim of this study is to assess feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. The secondary aim was to assess acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. Methods This will be a feasibility study which will consist of scientific investigations that will support movement of evidence-based, effective health care approach, SPADe, from the clinical knowledge base into routine use. This study will consist three phases: phase 1 will introduce SPADe in antenatal clinics in Blantyre District where screening of depression is almost none existent; phase 2 will implement screening of depression using SPADe in antenatal clinics in Blantyre District; and phase 3 will evaluate the screening of antenatal depression using SPADe to establish its feasibility, acceptability and fidelity in antenatal clinics in Blantyre District. Discussion This study will establish and document feasibility, acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. It is expected that midwives will develop more confidence in detecting and dealing with antenatal depression. Consequently, there will be increased numbers of pregnant women detected with depression by midwives and increased accessibility to mental health care by pregnant women in antenatal clinics.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

Chorwe‐Sungani

Mwagomba

Kulisewa

et al. 2021

Pilot Feasibility Stud

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High Rates of Biomarker-Confirmed Alcohol Use Among Pregnant Women Living With HIV in South Africa and Uganda

Raggio

Psaros

Fatch

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Alcohol use is common among people living with HIV and particularly harmful during pregnancy. However, objective data on alcohol use in pregnant women living with HIV (WLWH) are lacking. In areas with high levels of alcohol use generally, such as South Africa and Uganda, these data are needed to inform interventions. Methods: Pregnant and nonpregnant, antiretroviral therapy-naive WLWH were recruited from outpatient clinics in South Africa and Uganda. Women provided self-report data on previous three-month alcohol use and potential mental health correlates of alcohol use (depression and stigma). Blood samples were used to measure phosphatidylethanol (PEth), an objective biomarker of recent alcohol intake. We analyzed any alcohol use (ie, any self-reported use or PEth-positive [≥8 ng/mL]) and under-reporting of alcohol use (ie, no self-reported use with concurrent PEth-positive). Results: Among pregnant WLWH (n = 163, median age was 26 [interquartile range: 23–29], median gestational age was 20 weeks [interquartile range: 16–26]), 40% were using alcohol and 16% under-reported alcohol use. Neither any alcohol use nor under-reporting of alcohol use differed significantly between pregnant and nonpregnant women or by country (P > 0.05). Greater depression (but not greater stigma) was significantly associated with any alcohol use (adjusted odds ratio = 1.41, 95% confidence interval: [1.01 to 1.99]; P = 0.045). Conclusions: Alcohol use was prevalent and under-reported among pregnant WLWH in South Africa and Uganda, similar to nonpregnant participants, and associated with depression. General health care and antenatal clinic settings present opportunities to provide integrated alcohol-based counseling and depression treatment.

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A Brief Depression Screening Tool for Perinatal Clinical Practice: The Performance of the PHQ‐2 Compared with the PHQ‐9

Gigantesco¹,

Palumbo²,

Cena

et al. 2022

J Midwife Womens Health

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Introduction:There is ongoing interest in using brief screening instruments to identify perinatal depression in clinical practice. One ultra-brief screening instrument for depression is the Patient Health Questionnaire-2 (PHQ-2), but thus far its accuracy in perinatal clinical practice has been barely researched. In the present study, we aimed to assess the screening accuracy of the PHQ-2 against the Patient Health Questionnaire-9 (PHQ-9) in a large sample of perinatal women.Method: A total of 1155 consecutive women attending 11 health care centers throughout Italy completed the PHQ-9 (which includes the PHQ-2) during pregnancy (27-40 weeks) or postpartum (1-13 weeks). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative, and overall accuracy were calculated using cut points 3 or greater and 2 or greater.Results: During pregnancy, PHQ-2 greater than or equal to 3 revealed low sensitivity (38.4%-44.7%) but high specificity (97.8%-99.3%). In postpartum, it revealed moderate sensitivity (56.9%-70.6%), high specificity (95.8%-99.8%), and fair overall accuracy in pregnancy (70%). The alternative threshold greater than or equal to 2 revealed very high sensitivity (pregnancy: 92.1%-95.2%; postpartum: 87.1%-95.2%), moderate specificity (pregnancy: 78.1%-83.2%; postpartum: 68.8%-81.1%) and good overall accuracy, both during pregnancy (87%) and postpartum (84%). Discussion:The PHQ-2 provided acceptable accuracy for screening for depression compared with the PHQ-9. In perinatal screening practice, a threshold of 2 or greater should be preferred as this ensures high sensitivity, missing only approximately 6% to 8% of cases, and a false-positive rate (percentage of women classified as affected with depressive symptoms when they are not) of 19% to 25%.

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Validity and utility of instruments for screening of depression in women attending antenatal clinics in Blantyre district in Malawi

Cited by 9 publications

References 34 publications

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

High Rates of Biomarker-Confirmed Alcohol Use Among Pregnant Women Living With HIV in South Africa and Uganda

A Brief Depression Screening Tool for Perinatal Clinical Practice: The Performance of the PHQ‐2 Compared with the PHQ‐9

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