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Automated depression screening in disadvantaged pregnant women in an urban obstetric clinic

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Summary

Objective: A promising means of screening for depression among high-risk perinatal women involves interactive voice response (IVR) technology in which patients self-enter data into a database using a touch tone telephone. Our aim was to test the feasibility of using IVR to screen for depression among low-income, urban pregnant patients and to solicit their preferences for treatment.

Methods: The study population included a convenience sample of English-speaking pregnant patients awaiting routine prenatal visits in an urban obstetric clinic. Consenting subjects used a phone in a private clinic room to complete an IVR version of the Edinburgh Postnatal Depression Scale (EPDS). Patients scoring in the “not depressed” range were branched to a closing message while those with mild to severe depressive symptoms were branched to additional automated questions about their treatment preferences.

Results: All 54 participants who consented to the study were able to complete the IVR phone session. More than 90% expressed willingness to complete IVR interviews as part of routine prenatal and postpartum care. Sixteen out of 54 participants (29.6%) scored in the moderate to severe range for depressive symptoms (EPDS ≥ 12) which was consistent with a prior study in the same population using a validated paper-pencil screen. Only 12 out of 21 (57%) depressed subjects indicated a desire to speak with a health care provider about how they are feeling. The majority of these depressed subjects preferred to speak with a social worker about housing or financial problems (92%) or an obstetrician or midwife (83%), while a minority (42%) wanted to speak with a mental health professional.

Conclusions: This pilot study suggests that it is feasible to use an automated phone interview to screen for depression in low-income, urban pregnant women.

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References

  • J Agel T Rockwood JC Mundt JH Greist M Swiontkowski (2001) ArticleTitleComparison of interactive voice response and written self-administered patient surveys for clinical research Orthopedics 24 1155–1157 Occurrence Handle11770093 Occurrence Handle1:STN:280:DC%2BD38%2FktlaisA%3D%3D

    PubMed  CAS  Google Scholar 

  • J Alvidrez F Azocar (1999) ArticleTitleDistressed women’s clinic patients: preferences for mental health treatments and perceived obstacles Gen Hosp Psychiatry 21 340–347 Occurrence Handle10572775 Occurrence Handle10.1016/S0163-8343(99)00038-9 Occurrence Handle1:STN:280:DC%2BD3c%2FjvFSksg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • BB Brodey CS Rosen IS Brodey B Sheetz J Unutzer (2005) ArticleTitleReliability and acceptability of automated telephone surveys among Spanish- and English-speaking mental health services recipients Ment Health Serv Res 7 181–184 Occurrence Handle16194003 Occurrence Handle10.1007/s11020-005-5786-1

    Article  PubMed  Google Scholar 

  • TS Brugha S Wheatley NA Taub A Culverwell T Friedman P Kirwan DR Jones DA Shapiro (2000) ArticleTitlePragmatic randomized trial of antenatal intervention to prevent post-natal depression by reducing psychosocial risk factors Psychol Med 30 1273–1281 Occurrence Handle11097068 Occurrence Handle10.1017/S0033291799002937 Occurrence Handle1:STN:280:DC%2BD3M7isl2mtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • AE Buist BEW Barnett J Milstrom S Pope JT Condon DA Ellwood PM Boyce MPV Austin BA Hayes (2002) ArticleTitleTo screen or not to screen – that is the question in perinatal depression MJA 177 S101–S105 Occurrence Handle12358566

    PubMed  Google Scholar 

  • IA Cardone JJ Kim TEJ Gordon SM Gordon RK Silver (2006) ArticleTitlePsychosocial assessment by phone for high-scoring patients taking the Edinburgh Postnatal Depression Scale: communication pathways and strategies Arch Womens Ment Health 9 87–94 Occurrence Handle16292467 Occurrence Handle10.1007/s00737-005-0110-z Occurrence Handle1:STN:280:DC%2BD287ivVarug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • FA Carter JD Carter SE Luty DA Wilson CM Frampton PR Joyce (2005) ArticleTitleScreening and treatment for depression during pregnancy: a cautionary note Aust N Z J Psych 39 255–261 Occurrence Handle10.1111/j.1440-1614.2005.01562.x

    Article  Google Scholar 

  • CH Chen YF Tseng FH Chou SY Wang (2000) ArticleTitleEffects of support group intervention in postnatally distressed women: a controlled study in Taiwan J Psychosom Res 49 395–399 Occurrence Handle11182431 Occurrence Handle10.1016/S0022-3999(00)00180-X Occurrence Handle1:STN:280:DC%2BD3MzltlOgtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JL Cox JM Holden R Sagovsky (1987) ArticleTitleDetection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale Br J Psychiatry 150 782–786 Occurrence Handle3651732 Occurrence Handle1:STN:280:BieD3c7it1E%3D Occurrence Handle10.1192/bjp.150.6.782

    Article  PubMed  CAS  Google Scholar 

  • JL Cox G Chapman D Murray P Jones (1996) ArticleTitleValidation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women J Affect Disord 39 185–189 Occurrence Handle8856422 Occurrence Handle10.1016/0165-0327(96)00008-0 Occurrence Handle1:STN:280:ByiD3cbjtFM%3D

    Article  PubMed  CAS  Google Scholar 

  • RH Kelly DF Zatzick TF Anders (2001) ArticleTitleThe detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics Am J Psychiatry 158 213–219 Occurrence Handle11156803 Occurrence Handle10.1176/appi.ajp.158.2.213 Occurrence Handle1:STN:280:DC%2BD3M7ktFKjtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • HG Kim M Mandell C Crandall MA Kuskowski B Dieperink RL Buchberger (2006) ArticleTitleAntenatal psychiatric illness and adequacy of prenatal care in an ethnically diverse inner-city obstetric population Arch Womens Ment Health 9 103–107 Occurrence Handle16380813 Occurrence Handle10.1007/s00737-005-0117-5 Occurrence Handle1:STN:280:DC%2BD283kvFenuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • KA Kobak L Taylor S Dottl JH Greist JW Jefferson D Burroughs JM Mantle DJ Katzelnick R Norton HJ Henk RC Serlin (1997) ArticleTitleA computer-administered telephone interview to identify mental disorders JAMA 278 905–910 Occurrence Handle9302242 Occurrence Handle10.1001/jama.278.11.905 Occurrence Handle1:STN:280:ByiH2crpsFA%3D

    Article  PubMed  CAS  Google Scholar 

  • KA Kobak JC Mundt JH Greist DJ Katzelnick JW Jefferson (2000) ArticleTitleComputer assessment of depression: automating the Hamilton depression rating scale Drug Inform J 34 145–156

    Google Scholar 

  • M Kutner E Greenberg Y Jin C Paulsen (2006) The health literacy of America’s adults: results from the 2003 national assessment of adult literacy. NCES2006-483 SeriesTitleNational center for education statistics US Department of Education Washington, DC

    Google Scholar 

  • H Lee ME Friedman P Cukor D Ahern (2003) ArticleTitleInteractive voice response system (IVRS) in health care services Nurs Outlook 51 277–283 Occurrence Handle14688763 Occurrence Handle10.1016/S0029-6554(03)00161-1

    Article  PubMed  Google Scholar 

  • J Lumley MP Austin (2001) ArticleTitleWhat interventions may reduce postpartum depression Curr Opin Obstet Gynecol 13 605–611 Occurrence Handle11707664 Occurrence Handle10.1097/00001703-200112000-00009 Occurrence Handle1:STN:280:DC%2BD38%2FivVKgsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • S Matthey C Henshaw S Elliott B Barnett (2006) ArticleTitleVariability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale – implications for clinical and research practice Arch Womens Ment Health 9 309–315 Occurrence Handle17013761 Occurrence Handle10.1007/s00737-006-0152-x Occurrence Handle1:STN:280:DC%2BD28nls12gtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • J Miranda JY Chung BL Green J Krupnick J Siddique DA Revicki T Belin (2003) ArticleTitleTreating depression in predominantly low-income young minority women: a randomized controlled trial JAMA 290 57–65 Occurrence Handle12837712 Occurrence Handle10.1001/jama.290.1.57

    Article  PubMed  Google Scholar 

  • AM Mitchell ME Mittelstaedt D Schott-Baer (2006) ArticleTitlePostpartum depression: the reliability of telephone screening MCN Am J Matern Child Nurs 31 IssueID6 383–387 Occurrence Handle10.1097/00005721-200611000-00010

    Article  Google Scholar 

  • HK Moore JC Mundt JG Modell HE Rodrigues DJ DeBrota JJ Jefferson JH Greist (2006) ArticleTitleAn examination of 26,168 Hamilton depression rating scale scores administered via interactive voice response across 17 randomized clinical trials J Clin Psychopharmacol 26 IssueID3 321–324 Occurrence Handle16702899 Occurrence Handle10.1097/01.jcp.0000219918.96434.4d Occurrence Handle1:CAS:528:DC%2BD28XksFKnsbg%3D

    Article  PubMed  CAS  Google Scholar 

  • JC Mundt DJ Katzelnick SH Kennedy BS Eisfeld BB Bouffard JH Greist (2006) ArticleTitleValidation of an IVRS version of the MADRS J Psychiatr Res 40 IssueID3 243–246 Occurrence Handle15979643 Occurrence Handle10.1016/j.jpsychires.2005.05.002

    Article  PubMed  Google Scholar 

  • D Murray JL Cox (1990) ArticleTitleScreening for depression during pregnancy with the Edinburgh Postnatal Depression Scale J Reprod Infant Psychol 8 99–107

    Google Scholar 

  • R Nonacs LS Cohen (2002) ArticleTitleDepression during pregnancy: diagnosis and treatment options J Clin Psychiatry 63 IssueIDSuppl 17 24–30 Occurrence Handle11995775

    PubMed  Google Scholar 

  • CD Sherbourne M Dwight-Johnson R Klap (2001) ArticleTitlePsychological distress, unmet need, and barriers to mental health care for women Womens Health Iss 11 231–243 Occurrence Handle10.1016/S1049-3867(01)00086-X Occurrence Handle1:STN:280:DC%2BD3MzotlKgtQ%3D%3D

    Article  CAS  Google Scholar 

  • RL Spitzer JB Williams K Kroenke R Hornyak J McMurray (2000) ArticleTitleValidity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric/gynecologic patients: the PRIME-MD patient health questionnaire obstetric-gynecology study Am J Obstet Gynecol 183 759–769 Occurrence Handle10992206 Occurrence Handle10.1067/mob.2000.106580 Occurrence Handle1:STN:280:DC%2BD3cvksVymuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • IME Sundstrom M Bixo I Bjorn M Amstrom (2001) ArticleTitlePrevalence of psychiatric disorders in gynecologic outpatients Am J Obstet Gynecol 184 8–13 Occurrence Handle11174472 Occurrence Handle10.1067/mob.2001.108072 Occurrence Handle1:STN:280:DC%2BD3MzivVWmsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MV Williams RM Parker DW Baker NS Parikh K Pitkin WC Coates JR Nurss (1995) ArticleTitleInadequate functional health literacy among patients at 2 public hospitals JAMA 274 1677–1682 Occurrence Handle7474271 Occurrence Handle10.1001/jama.274.21.1677 Occurrence Handle1:STN:280:BymD1cfptlc%3D

    Article  PubMed  CAS  Google Scholar 

  • KL Wisner BL Parry CM Piontek (2002) ArticleTitlePostpartum depression NEJM 347 IssueID3 194–199 Occurrence Handle12124409 Occurrence Handle10.1056/NEJMcp011542

    Article  PubMed  Google Scholar 

  • P Zelkowitz TH Milet (1995) ArticleTitleScreening for post-partum depression in a community sample Can J Psychiatry Rev Can Psych 40 80–86 Occurrence Handle1:STN:280:ByqA3cfktlI%3D

    CAS  Google Scholar 

  • C Zlotnick SL Johnson IW Miller T Pearlstein M Howard (2001) ArticleTitlePostpartum depression in women receiving public assistance: pilot study of an interpersonal-therapy-oriented group intervention Am J Psychiatry 158 638–640 Occurrence Handle11282702 Occurrence Handle10.1176/appi.ajp.158.4.638 Occurrence Handle1:STN:280:DC%2BD3M3ivVOjsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Hennepin Women’s Mental Health Program, Hennepin County Medical Center, Minneapolis, MN, USA

    H. Kim & A. Tipnis

  2. Center for Urban Health, Hennepin County Medical Center, Minneapolis, MN, USA

    Y. Bracha

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  1. H. Kim
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  2. Y. Bracha
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  3. A. Tipnis
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Kim, H., Bracha, Y. & Tipnis, A. Automated depression screening in disadvantaged pregnant women in an urban obstetric clinic. Arch Womens Ment Health 10, 163–169 (2007). https://doi.org/10.1007/s00737-007-0189-5

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