While we have focused a great deal on the emergence of mood disorders during pregnancy and the postpartum period, there is a growing body of literature that indicates that anxiety symptoms are prevalent during this period of time and may also affect pregnancy outcomes.  Certain items on the Edinburgh Postnatal Depression Scale (EPDS) may help to identify women with anxiety, but it is likely that this scale does not identify all women with clinically relevant anxiety.

Researchers in Western Australia have developed a new scale – the Perinatal Anxiety Screening Scale or PASS — to specifically screen for a broad range of anxiety symptoms. This 31-item questionnaire is easy to complete and score, is sensitive to how anxiety presents in perinatal women and may be used  in a variety of settings.  In a pilot study, women who attended an obstetric hospital (n?=?437) completed the PASS and other commonly used measures of depression and anxiety.  The subjects were assessed but during pregnancy and the postpartum period.

The PASS is the first survey to date that screens for a broad range of anxiety disorders, as well as some common fears specific to the perinatal period. The PASS presents as a valid and useful instrument for the identification of pregnant women and new mothers who present with problematic anxiety. The PASS identified 68 % of women with a diagnosed anxiety disorder. This was compared to the EPDS anxiety subscale which detected only 36 % of women with anxiety disorders. This scale assesses for four categories of anxiety: (1) acute anxiety and adjustment, (2) general worry and specific fears, (3) perfectionism, control and trauma and (4) social anxiety. Further validation in clinical populations is warranted and may help to refine its usefulness by identifying subsets of questions that may be used to identify specific anxiety disorders.

Here is a downloadable copy of the PASS from the Western Australia Department of Health.

Ruta Nonacs, MD PhD

Somerville S, Dedman K, Hagan R, et al. The Perinatal Anxiety Screening Scale: development and preliminary validation.  Arch Womens Ment Health. 2014 Apr 4. [Epub ahead of print]

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