Comparison of four self-report measures and a generic mood question to screen for anxiety during pregnancy in English-speaking women

Background: Increasingly researchers and clinicians have called for perinatal mental health depression screening to be broadened to also screen for significant levels of anxiety. This study therefore aimed to compare the screening performance during pregnancy of four self-report anxiety measures, as well as a generic mood question. Method: The measures tested were two measures of general anxiety (the anxiety subscales of the Edinburgh Depression Scale and the Hospital Anxiety and Depression Scale), and two measures of pregnancy specific anxiety by Huizink and colleagues, and Rini and colleagues (both originally called the Pregnancy-Related Anxiety Questionnaire). A generic mood question (Matthey Generic Mood Question) asking about stress, anxiety, unhappiness or difficulty coping was also tested. Between 132 and 389 women completed these measures at their first antenatal clinic appointment and up to 249 women completed a diagnostic interview and various measures two weeks later. Results: The generic mood question performed best, detecting between 58% and 87% of high scorers on the other measures, including 80% of the women with an anxiety disorder. The next best measure was the EDS anxiety subscale, detecting between 26% and 73% of high scorers on the other measures, though this only detected 54% of the women with an anxiety disorder. Limitations: Findings are only applicable to English-speaking women. In addition whether the findings can be applied to women later in their pregnancy, or postpartum, is not known. Conclusion: Services wishing to screen for not only possible depression but also possible anxiety should use the generic mood question. For those services which currently use the EDS we recommend they also score the three-item anxiety subscale.