The Pregnancy Depression Scale (PDS): a screening tool for depression in pregnancy.
ABSTRACT Depression in pregnancy can be underdiagnosed as a consequence of the symptoms being misattributed to "normal pregnancy." There are currently no validated clinician-rated scales that assess for depression specifically during pregnancy. We sought to develop a brief, convenient screening tool to identify depression in pregnant women in the community setting. Prospective mood data using the 28-item Hamilton Depression Rating Scale (HDRS) were collected monthly in 196 pregnant women with a history of a major depressive disorder. These data were analyzed to delineate those HDRS items associated (elevated) with normal pregnancy vs. those indicative of a pregnant woman meeting diagnostic criteria for a major depressive episode. Endorsement of symptoms on seven items of the HDRS were highly predictive of having a major depressive episode during pregnancy. We present a well-validated, brief scale to screen pregnant women for clinical depression. Whether this study will generalize to women who do not have a history of major depression remains to be studied.
SourceAvailable from: Mijke P Lambregtse-van den Berg[Show abstract] [Hide abstract]
ABSTRACT: Mental disorders are prevalent during pregnancy, affecting 10% of women worldwide. To improve triage of a broad spectrum of mental disorders, we investigated the decision impact validity of: 1) a short set of currently used psychiatric triage items, 2) this set with the inclusion of some more specific psychiatric items (intermediate set), 3) this new set with the addition of the 10-item Edinburgh Depression Scale (extended set), and 4) the final set with the addition of common psychosocial co-predictors (comprehensive set). This was a validation study including 330 urban pregnant women. Women completed a questionnaire including 20 psychiatric and 10 psychosocial items. Psychiatric diagnosis (gold standard) was obtained through Structured Clinical Interviews of DSM-IV axis I and II disorders (SCID-I and II). The outcome measure of our analysis was presence (yes/no) of any current mental disorder. The performance of the short, intermediate, extended, and comprehensive triage models was evaluated by multiple logistic regression analysis, by analysis of the area under the ROC curve (AUC) and through associated performance measures, including, for example, sensitivity, specificity and the number of missed cases. Diagnostic performance of the short triage model (1) was acceptable (Nagelkerke's R(2)=0.276, AUC=0.740, 48 out of 131 cases were missed). The intermediate model (2) performed better (R(2)=0.547, AUC=0.883, 22 cases were missed) including the five items: ever experienced a traumatic event, ever had feelings of a depressed mood, ever had a panic attack, current psychiatric symptoms and current severe depressive or anxious symptoms. Addition of the 10-item Edinburgh Depression Scale or the three psychosocial items unplanned pregnancy, alcohol consumption and sexual/physical abuse (models 3 and 4) further increased R(2) and AUC (>0.900), with 23 cases missed. Missed cases included pregnant women with a current eating disorder, psychotic disorder and the first onset of anxiety disorders. For a valid detection of the full spectrum of common mental disorders during pregnancy, at least the intermediate set of five psychiatric items should be implemented in routine obstetric care. For a brief yet comprehensive triage, three high impact psychosocial items should be added as independent contributors.BMC Pregnancy and Childbirth 12/2015; 15(1):480. DOI:10.1186/s12884-015-0480-9 · 2.15 Impact Factor
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ABSTRACT: Search Engine Marketing (SEM) is the practice of manipulating and/or paying the search engines (Google, Yahoo!, Bing, etc.) to drive traffic to websites. The SEM community has developed techniques that can channel visitors to websites; however, little work has been done to develop models able to estimate the amount of traffic generated by SEM. In this paper, we develop formulae that can be used to estimate traffic resulting from SEM campaigns that can be used by search marketing agencies for competition analysis and by web hosting providers for performance analysis and capacity planning. Our experimental results show that our models work best for targeted marketing campaigns, but the formulae presented can be generalized to broader marketing domains.Computer Standards & Interfaces 11/2012; DOI:10.1016/j.csi.2011.10.008 · 1.18 Impact Factor
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ABSTRACT: Pregnancy represents a unique period of time when women are at an increased risk of developing depression. Although the Beck Depression Inventory-Second Edition (BDI-II) is one of the most widely used self-report measures of depression symptomology, its psychometric properties and underlying factor structures have not been determined for antenatal women and among Latinas. The current study evaluated the latent symptom structure of the BDI-II in a community-based sample of Latina pregnant women (N = 217) identified to be at high risk for depression. Exploratory factor analyses were used to identify underlying salient individual item loadings for two- and three-factor models. Confirmatory factor analyses then examined several different indices to determine the best model fit. Examination of exploratory and confirmatory factor analyses supports a three-factor oblique structure of the BDI-II composed of Cognitive-Affective, Somatic, and Pregnancy Symptoms. The three-factor model provides clinicians with the ability to target specific constellations of depressive symptoms instead of relying on the BDI-II total score that represents the overall severity of depression in this population.Maternal and Child Health Journal 08/2013; DOI:10.1007/s10995-013-1343-5 · 2.24 Impact Factor