Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care

Perinatal depression currently receives considerable attention, but not all perinatal women presenting for psychiatric care
are depressed. The Edinburgh Postnatal Depression Scale (EPDS) is now routinely administered, but high scores are interpreted
as evidence for depressive illness only. This study examined psychiatric diagnoses and mean EPDS scores among perinatal women
at a tertiary center. Women accessing care between March 2006 and June 2008 completed a clinical diagnostic interview and
the EPDS. Mean EPDS scores were calculated for each psychiatric diagnosis; sensitivity and specificity were calculated for
major depressive episode (MDE) and generalized anxiety disorder (GAD). The majority of the sample (N = 91), 49.5%, had GAD comorbid with MDE or another anxiety disorder, followed by MDE (38.5%) comorbid with an anxiety disorder.
One third (29.7%) met criteria for MDE and GAD. Only 3.3% had MDE alone and 5.5% had GAD alone. Half the sample (50.5%) had
more than one psychiatric disorder. Mean EPDS scores exceeded 11 for the majority of diagnostic groups. Sensitivity of the
EPDS for MDE was 0.78 and 0.70 for GAD. Most women had an anxiety disorder and met criteria for more than one psychiatric
disorder. Mean EPDS scores were consistently high. Sensitivity of the EPDS for MDE and GAD was comparable.