Screening for maternal depression in pediatric clinics

K. J. Kemper and T. R. Babonis
Department of Pediatrics, Harborview Medical Center, Seattle, WA 98104.

OBJECTIVE--The purpose of this study was to assess the frequency of and risk factors for depressive disorders among mothers of young children and to compare the eight-item RAND screening instrument for depressive disorders with an easily scored three-item version of the test. DESIGN--A cross-sectional survey. SETTING--Five pediatric clinics in the Seattle-Tacoma, Washington area, two private practices, two university-affiliated teaching clinics, and the Madigan Army Medical Center pediatric clinic. PARTICIPANTS--Convenience sample of 667 English-speaking mothers who completed the depression items on an anonymous self-administered questionnaire on family health. INTERVENTIONS--None. MEASUREMENTS AND RESULTS--The results of women surveyed showed that 19% were positive for depression on the RAND instrument. Women whose survey results were positive were younger (28.2 vs 30.3 years of age), had less education (12.9 vs 14.4 years), and had lower monthly incomes ($1803 vs $2923) than those who results were not positive. Positive scores were more common among women surveyed in teaching clinics (20%) and military clinics (24%) than among women surveyed in private practices (12%), among single vs married mothers (32% vs 15%), among nonwhites vs whites (29% vs 16%), and among those with positive screening test results for drugs compared with those with negative screening test results (45% vs 17%) (P less than .01 for all comparisons). Compared with the eight-item instrument, the three-item version had a sensitivity of 100%, a specificity of 88%, and a positive predictive value of 66%. CONCLUSIONS--Depression is common among mothers of young children. The three-item version compares favorably with the eight-item RAND screening instrument for depressive disorders.

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