Problems with a Diagnostic Depression Interview in a Postpartum Depression Trial

Dwenda Gjerdingen; Patricia McGovern; Bruce Center

doi:10.3122/jabfm.2011.02.100197

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Table 1.

Participants' Demographic Characteristics (n = 506)

Characteristic	Value
Age (mean yr [SD])	29.1 (6.2)
Married	328 (64.8)
Have only one child	207 (41.7)
Employed (working at a job or on leave)	322 (63.6)
Race/ethnicity
White	339 (67.0)
Black or African American	89 (17.6)
Asian	34 (6.7)
Multiracial	17 (3.4)
Other	27 (5.3)
Total family annual income
<$20,000	133 (27.3)
$20,000–$79,999	177 (36.3)
≥$80,000	178 (36.5)
Education
<High school diploma	81 (16.1)
≥4-year degree	263 (52.2)
Health Insurance
Private insurance	257 (55.3)
Medical assistance	142 (30.5)

Values are provided as n (%) unless otherwise indicated.

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Table 2.

Women with Positive Patient Health Questionnaire 9 (PHQ-9) and Structured Clinical Interview for Diagnostic and Statistical Manual (DSM) Disorders (SCID) by Interval

Depression Screen or Interview	0–1 Month (n = 506)	2 Months (n = 464)	4 Months (n = 459)	6 Months (n = 455)	9 Months (n = 472)	Total^* (n = 506)
PHQ-9	63 (12.5)	33 (7.1)	32 (7.0)	23 (5.0)	48 (10.2)	112 (22.1)
SCID	20^† (4.0)	9 (1.9)	4 (0.9)	6 (1.3)	6 (1.3)	45 (8.9)

Values provided as n (%).
↵* “Total” refers to the total number of women who had a positive result sometime between 0 and 9 months postpartum.
↵† Most SCID interviews were conducted at 0 to 1 month postpartum. Thereafter, SCID interviews were only performed for screen-positive women who had not previously had a positive SCID.

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Table 3.

Differences in Characteristics between Women Who Completed the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM) Disorders (SCID) at 0 to 1 Months and Those Who Did Not*

Characteristics	SCID Noncompleters (n = 68)	SCID Completers (n = 438)	P^*
Age (mean yr)	26.4	29.6	.000
>High school education	32 (47.1)	324 (74.3)	.000
Married	25 (37.3)	303 (69.5)	.000
Race
Black	26 (38.2)	65 (14.8)
White	35 (51.5)	320 (73.1)
Other	7 (10.3)	53 (12.1)	.000
Insured through medical assistance	31 (50.8)	112 (28.1)	.000
Annual family income <$20,000	33 (50.8)	100 (23.6)	.000
PHQ-9 total score (mean)	4.4	4.5	NS

Values provided as n (%) unless otherwise indicated.
↵* Determined by t tests and χ² tests.
† P values for age and Patient Health Questionnaire 9 (PHQ-9) were determined by t tests; P values for all other variables were determined by χ² tests.

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Table 4.

Responses of Participants to the “Difficulty” Question by Survey Interval: Number of Women with Positive Versus Negative Patient Health Questionnaire 9 Scores

Postpartum Interval (Months)	How Difficult Have These Problems (Depressive Symptoms) Made It for You To Do Your Work, Take Care of Things at Home, or Get Along With Other People?
Postpartum Interval (Months)	1 (Not At All Difficult)	2 (Somewhat Difficult)	3 (Very Difficult)	4 (Extremely Difficult)	Sum of Columns 2–4^*
0–1	6 (198)	41 (165)	12 (3)	3 (1)	56 (90.3) (169 [46.0])
2	0 (203)	19 (108)	11 (2)	3 (0)	33 (100) (110 [35.1])
4	2 (161)	16 (120)	10 (0)	4 (0)	30 (93.8) (120 [42.7])
6	1 (172)	11 (118)	7 (1)	3 (1)	21 (95.5) (120 [41.1 ])
9	3 (169)	25 (138)	19 (2)	1 (0)	45 (93.8) (140 [45.3])

Numbers represent the number of women with positive Patient Health Questionnaire 9 (PHQ-9) scores (total score ≥10). Numbers within parentheses represent the number of women with negative PHQ-9 scores. PHQ-9 positive women were significantly different from PHQ-9 negative women in their responses to the “difficulty” question at each interval (P < .001 by χ² test).
↵* Values provided as n (%).