Edinburgh Scale May Not Be Broad Enough to Identify Women With Postnatal Anxiety

A study recently conducted at the Swinburne University of Technology in Australia has found that the Edinburgh Postnatal Depression Scale (EPDS), while fairly accurately identifying women suffering from postpartum depression, often misses those women suffering postnatal anxiety without depressive symptoms.  As so much discussion lately has focused on the importance of requiring ob/gyns to screen women at the 6-week postnatal checkup, I think this study is highly important.  We must ensure that we use the best screening tool available once we are finally able to get screenings conducted with all women who've given birth.  As postpartum mood disorders cover a wide spectrum, we can't use a tool that may miss out on identifying certain women who are suffering.

According to the study, "... postnatal depression has received considerable research and clinical attention, however anxiety and stress in the postpartum has been relatively ignored. Along with the widespread use of the Edinburgh Postnatal Depression Scale (EPDS), depression has become the marker for postnatal maladjustment. Symptoms of anxiety tend to be subsumed within diagnoses of depression, which can result in anxiety being minimized or overlooked in the absence of depression. Some researchers have identified the need to distinguish between postnatal depression and anxiety, and to discern cases where depression and anxiety co-exist ... [Using the Depression Anxiety Stress Scale (DASS-21), a broader scale than the EPDS], found that 10% of the women in the study showed symptoms of anxiety and stress without depression ... The prevalence of anxiety and stress in the present study points to the importance of assessing postnatal women for broader indicators of psychological morbidity than that of depression alone. The DASS-21 appears to be a useful instrument for this purpose."