Various screening tools have been used to identify women with postpartum depression (PPD.  The most widely used self-report tools for detection of PPD are the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI) having ten and 21 items, respectively. However, the EPDS and the BDI may be too lengthy to use for quickly screening patients in obstetric, primary care, or pediatric settings.

A recent study assessed the accuracy of two screening instruments, comparing them to clinical interviews. 1,392 women within 12 months of delivery were screened for PPD using the Patient Health Questionnaire-9 (PHQ-9) and a six-item scale developed for the CDC Pregnancy Risk Assessment questions (PRAMS-6). Three item subscales of the PRAMS-6 were also evaluated— the 3-item PRAMS-3D subscale for depression (depressed mood, feeling hopeless, and feeling slowed down) and the 3-item PRAMS-3A subscale for anxiety (feeling panicky, feeling restless, and problems sleeping).

The PRAMS-6, PRAMS-3D, and PHQ-9 had similar levels of accuracy (78–82 %) for predicting PPD that was later confirmed by structured interviews (using the SCID).  One key difference among the screening instruments was the time period within which symptoms are assessed. The PHQ-9 covers symptoms over the last 2 weeks and the PRAMS addresses symptoms since the time of delivery.

Ruta Nonacs, MD PhD

Davis K, Pearlstein T, Stuart S, O’Hara M, Zlotnick C.  Analysis of brief screening tools for the detection of postpartum depression: Comparisons of the PRAMS 6-item instrument, PHQ-9, and structured interviews.  Arch Womens Ment Health. 2013 Aug; 16(4):271-7.

O’Hara MW, Stuart S, Watson D, Dietz PM, Farr SL, D’Angelo D. Brief scales to detect postpartum depression and anxiety symptoms.  J Womens Health (Larchmt). 2012 Dec; 21(12):1237-43.