Objectives
Depression during pregnancy is more frequent than in the postpartum and has been indicated as a risk factor for the latter. This study aims to detect and evaluate depressive manifestations across the perinatal period by means of the DESI (Depression Early Symptoms Inventory, A. Amati 1996-2004) a novel instrument, which has been compared with the 21-item Hamilton Depression Rating Scale (HDRS) as well as with the 13-item Beck Depression Inventory (BDI).
Methods
Fifty nine consecutive women at their first pregnancy (mean age 30 ± 5 years) were enrolled from the Outpatient Unit, Division of Obstetrics and Gynaecology, (Head prof. F. Zullo). They were interviewed and evaluated by means of the DESI, the HDRS, BDI. Additional evaluations have been carried-out by means of the EPDS and and Spielberger’s State-Trait Anxiety Inventory, Version Y1, State (STAI-Y1). Statistical analysis regarded item distribution, Spearman correlation, Cronbach’s alpha calculation, and factor analysis.
Results
Data were distributed over each one of the three trimesters of pregnancy (Table I): at the last trimester of pregnancy, DESI and BDI showed more sensitivity than other instruments to detect and quantify psychopathological variations. DESI items no. 6, 9, 13, 14, 27 as well as BDI items no. 1, 5, 7, 10 obtained highest scorings (Tables III, IV). Total DESI score relevant to depressive manifestations showed positive correlation with a history of risk factors (Table II), while the age of the subjects positively correlated with STAI scores and negatively with EPDS scores, respectively (Table V). DESI internal consistency (Cronbach alpha) proved to be 0.89. Factor analysis extracted 10 factors, explaining 76.237% of total variance (Table VI).
Conclusions
In this limited sample, subclinical depressive symptoms have been detected during the first pregnancy. They showed a trend to increase from the first to the third trimester. Statistical investigation confirmed high internal coherence as well as reliability of the novel instrument, DESI. It proved to be more sensitive than the reference instruments to detect subthreshold depressive manifestations in women with risk factors as well as to quantify severity variations across the trimesters of pregnancy. Our data need to be confirmed in a larger sample.