evidence and practice
Validity of a two-question tool in detecting antenatal depression in Malawi
Genesis Chorwe-Sungani Senior lecturer, community and mental health nursing, University of Malawi, Blantyre, Malawi
Jennifer Chipps Professor, School of Nursing, University of the Western Cape, Cape Town, South Africa
Diana Jere Associate professor, community and mental health nursing, University of Malawi, Blantyre, Malawi
Background Maternal depression is the second leading cause of disease burden in women of childbearing age but antenatal depression is often undetected due to a lack of routine screening in antenatal clinics.
Aim To establish the validity of a two-question tool based on the Whooley questions in detecting antenatal depression in the Blantyre district, Malawi.
Method A sensitivity analysis study was used with a sample of 97 pregnant women from eight antenatal clinics. Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were calculated to test for validity of the Whooley questions. A binary logistic regression model was used to compute odds ratios to test the ability of the instrument to predict antenatal depression.
Results Whooley’s questions (cut off ≥1) had a sensitivity of 92%, a specificity of 65.3% with an AUC of 0.81 (95% confidence interval 0.7-0.9, P<0.001). The instrument predicted major depression in pregnant women, and women who screened positive were five times more likely to experience major depression.
Conclusion The Whooley questions could be a useful tool for preliminary screening of depression in local antenatal clinics where screen positives could be further assessed for depression using a diagnostic assessment.
Mental Health Practice. doi: 10.7748/mhp.2019.e1392Peer review
This article has been subject to external double-blind peer review and has been checked for plagiarism using automated softwareCorrespondence
Chorwe-Sungani G, Chipps J, Jere D (2019) Validity of a two-question tool in detecting antenatal depression in Malawi. Mental Health Practice. doi: 10.7748/mhp.2019.e1392
Acknowledgements We acknowledge all colleagues who offered guidance and technical support towards the writing of this article
Published online: 01 October 2019