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This is a repository copy of Identifying perinatal depression with case-finding instruments : a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy). White Rose Research Online URL for this paper: https://eprints.whiterose.ac.uk/134342/ Version: Published Version Article: Littlewood, Elizabeth orcid.org/0000-0002-4606-4590, Ali, Shehzad orcid.org/0000-0002- 8042-3630, Dyson, Lisa et al. (26 more authors) (2018) Identifying perinatal depression with case-finding instruments : a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy). Health Services and Delivery Research. pp. 1-244. ISSN 2050-4357 https://doi.org/10.3310/hsdr06060 Reuse Items deposited in White Rose Research Online are protected by copyright, with all rights reserved unless indicated otherwise. They may be downloaded and/or printed for private study, or other acts as permitted by national copyright laws. 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[email protected] https://eprints.whiterose.ac.uk/ HEALTH SERVICES AND DELIVERY RESEARCH VOLUME 6 ISSUE 6 FEBRUARY 2018 ISSN 2050-4349 Identifying perinatal depression with case-finding instruments: a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy) Elizabeth Littlewood, Shehzad Ali, Lisa Dyson, Ada Keding, Pat Ansell, Della Bailey, Debrah Bates, Catherine Baxter, Jules Beresford-Dent, Arabella Clarke, Samantha Gascoyne, Carol Gray, Lisa Hackney, Catherine Hewitt, Dorothy Hutchinson, Laura Jefferson, Rachel Mann, David Marshall, Dean McMillan, Alice North, Sarah Nutbrown, Emily Peckham, Jodi Pervin, Zoe Richardson, Kelly Swan, Holly Taylor, Bev Waterhouse, Louise Wills, Rebecca Woodhouse and Simon Gilbody DOI 10.3310/hsdr06060 Identifying perinatal depression with case-finding instruments: a mixed-methods – study (BaBY PaNDA Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy) Elizabeth Littlewood,1 Shehzad Ali,1 Lisa Dyson,2 Ada Keding,2 Pat Ansell,3 Della Bailey,1 Debrah Bates,4 Catherine Baxter,5 Jules Beresford-Dent,5 Arabella Clarke,2 Samantha Gascoyne,1 Carol Gray,4 Lisa Hackney,5 Catherine Hewitt,2 Dorothy Hutchinson,4 Laura Jefferson,2 Rachel Mann,6 David Marshall,5 Dean McMillan,1,7 Alice North,8 Sarah Nutbrown,1 Emily Peckham,1 Jodi Pervin,1 Zoe Richardson,2 Kelly Swan,3 Holly Taylor,5 Bev Waterhouse,3 Louise Wills,9 Rebecca Woodhouse1 and Simon Gilbody1,7* 1Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK 2York Trials Unit, Department of Health Sciences, University of York, York, UK 3Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK 4Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe General Hospital, Scunthorpe, UK 5Leeds and York Partnership NHS Foundation Trust, Bootham Park Hospital, York, UK 6Department of Health Sciences, University of York, York, UK 7Hull York Medical School, York, UK 8Patient and public involvement representative, York, UK 9Harrogate and District NHS Foundation Trust, Harrogate District Hospital, Harrogate, UK *Corresponding author Declared competing interests of authors: SimonGilbody isaHealth Technology Assessment (HTA) Evidence Synthesis Boardmember and aHTA EfficientStudy Designs Board member.Catherine Hewitt isa HTACommissioning Boardmember. Published February 2018 DOI: 10.3310/hsdr06060 This reportshould be referenced as follows: Littlewood E, Ali S, DysonL, KedingA, Ansell P, Bailey D, etal. Identifyingperinataldepression withcase-findinginstruments:amixed-methodsstudy(BaBYPaNDA–BornandBredinYorkshire PeriNatalDepressionDiagnosticAccuracy).HealthServDelivRes2018;6(6). Health Services and Delivery Research ISSN2050-4349(Print) ISSN2050-4357(Online) ThisjournalisamemberofandsubscribestotheprinciplesoftheCommitteeonPublicationEthics(COPE)(www.publicationethics.org/). Editorialcontact:[email protected] ThefullHS&DRarchiveisfreelyavailabletoviewonlineatwww.journalslibrary.nihr.ac.uk/hsdr.Print-on-demandcopiescanbepurchasedfrom thereportpagesoftheNIHRJournalsLibrarywebsite:www.journalslibrary.nihr.ac.uk CriteriaforinclusionintheHealthServicesandDeliveryResearchjournal ReportsarepublishedinHealthServicesandDeliveryResearch(HS&DR)if(1)theyhaveresultedfromworkfortheHS&DRprogramme orprogrammeswhichprecededtheHS&DRprogramme,and(2)theyareofasufficientlyhighscientificqualityasassessedbythe reviewersandeditors. HS&DRprogramme TheHealthServicesandDeliveryResearch(HS&DR)programme,partoftheNationalInstituteforHealthResearch(NIHR),wasestablishedto fundabroadrangeofresearch.ItcombinesthestrengthsandcontributionsoftwopreviousNIHRresearchprogrammes:theHealthServices Research(HSR)programmeandtheServiceDeliveryandOrganisation(SDO)programme,whichweremergedinJanuary2012. TheHS&DRprogrammeaimstoproducerigorousandrelevantevidenceonthequality,accessandorganisationofhealthservicesincluding costsandoutcomes,aswellasresearchonimplementation.Theprogrammewillenhancethestrategicfocusonresearchthatmatterstothe NHSandiskeentosupportambitiousevaluativeresearchtoimprovehealthservices. FormoreinformationabouttheHS&DRprogrammepleasevisitthewebsite:http://www.nets.nihr.ac.uk/programmes/hsdr Thisreport TheresearchreportedinthisissueofthejournalwasfundedbytheHS&DRprogrammeoroneofitsprecedingprogrammesasproject number11/2004/23.ThecontractualstartdatewasinApril2013.ThefinalreportbeganeditorialreviewinAugust2016andwasaccepted forpublicationinDecember2016.Theauthorshavebeenwhollyresponsibleforalldatacollection,analysisandinterpretation,andforwriting uptheirwork.TheHS&DReditorsandproductionhousehavetriedtoensuretheaccuracyoftheauthors’reportandwouldliketothankthe reviewersfortheirconstructivecommentsonthefinalreportdocument.However,theydonotacceptliabilityfordamagesorlossesarising frommaterialpublishedinthisreport. ThisreportpresentsindependentresearchfundedbytheNationalInstituteforHealthResearch(NIHR).Theviewsandopinionsexpressedby authorsinthispublicationarethoseoftheauthorsanddonotnecessarilyreflectthoseoftheNHS,theNIHR,NETSCC,theHS&DR programmeortheDepartmentofHealth.Ifthereareverbatimquotationsincludedinthispublicationtheviewsandopinionsexpressedbythe intervieweesarethoseoftheintervieweesanddonotnecessarilyreflectthoseoftheauthors,thoseoftheNHS,theNIHR,NETSCC,the HS&DRprogrammeortheDepartmentofHealth. ©Queen’sPrinterandControllerofHMSO2018.ThisworkwasproducedbyLittlewoodetal.underthetermsofa commissioningcontractissuedbytheSecretaryofStateforHealth.Thisissuemaybefreelyreproducedforthepurposesof privateresearchandstudyandextracts(orindeed,thefullreport)maybeincludedinprofessionaljournalsprovidedthat suitableacknowledgementismadeandthereproductionisnotassociatedwithanyformofadvertising.Applicationsfor commercialreproductionshouldbeaddressedto:NIHRJournalsLibrary,NationalInstituteforHealthResearch,Evaluation,Trials andStudiesCoordinatingCentre,AlphaHouse,UniversityofSouthamptonSciencePark,SouthamptonSO167NS,UK. PublishedbytheNIHRJournalsLibrary(www.journalslibrary.nihr.ac.uk),producedbyPrepressProjectsLtd,Perth,Scotland (www.prepress-projects.co.uk). Health Services and Delivery Research Editor-in-Chief Professor Jo Rycroft-Malone Professor of Health Services and Implementation Research, Bangor University, UK NIHR Journals Library Editor-in-Chief Professor Tom Walley Director, NIHR Evaluation, Trials and Studies and Director of the EME Programme, UK NIHR Journals Library Editors Professor Ken Stein Chair of HTA and EME Editorial Board and Professor of Public Health, University of Exeter Medical School, UK Professor Andrée Le May Chair of NIHR Journals Library Editorial Group (HS&DR, PGfAR, PHR journals) Dr Martin Ashton-Key Consultant in Public Health Medicine/Consultant Advisor, NETSCC, UK Professor Matthias Beck Professor of Management, Cork University Business School, Department of Management and Marketing, University College Cork, Ireland Dr Tessa Crilly Director, Crystal Blue Consulting Ltd, UK Dr Eugenia Cronin Senior Scientific Advisor, Wessex Institute, UK Dr Peter Davidson Director of the NIHR Dissemination Centre, University of Southampton, UK Ms Tara Lamont Scientific Advisor, NETSCC, UK Dr Catriona McDaid Senior Research Fellow, York Trials Unit, Department of Health Sciences, University of York, UK Professor William McGuire Professor of Child Health, Hull York Medical School, University of York, UK Professor Geoffrey Meads Professor of Wellbeing Research, University of Winchester, UK Professor John Norrie Chair in Medical Statistics, University of Edinburgh, UK Professor John Powell Consultant Clinical Adviser, National Institute for Health and Care Excellence (NICE), UK Professor James Raftery Professor of Health Technology Assessment, Wessex Institute, Faculty of Medicine, University of Southampton, UK Dr Rob Riemsma Reviews Manager, Kleijnen Systematic Reviews Ltd, UK Professor Helen Roberts Professor of Child Health Research, UCL Institute of Child Health, UK Professor Jonathan Ross Professor of Sexual Health and HIV, University Hospital Birmingham, UK Professor Helen Snooks Professor of Health Services Research, Institute of Life Science, College of Medicine, Swansea University, UK Professor Jim Thornton Professor of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Nottingham, UK Professor Martin Underwood Director, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, UK Please visit the website for a list of members of the NIHR Journals Library Board: www.journalslibrary.nihr.ac.uk/about/editors Editorial contact: [email protected] NIHRJournalsLibrary www.journalslibrary.nihr.ac.uk DOI:10.3310/hsdr06060 HEALTHSERVICESANDDELIVERYRESEARCH2018 VOL.6 NO.6 Abstract Identifying perinatal depression with case-finding – instruments: a mixed-methods study (BaBY PaNDA Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy) Elizabeth Littlewood,1 Shehzad Ali,1 Lisa Dyson,2 Ada Keding,2 Pat Ansell,3 Della Bailey,1 Debrah Bates,4 Catherine Baxter,5 Jules Beresford-Dent,5 Arabella Clarke,2 Samantha Gascoyne,1 Carol Gray,4 Lisa Hackney,5 Catherine Hewitt,2 Dorothy Hutchinson,4 Laura Jefferson,2 Rachel Mann,6 David Marshall,5 Dean McMillan,1,7 Alice North,8 Sarah Nutbrown,1 Emily Peckham,1 Jodi Pervin,1 Zoe Richardson,2 Kelly Swan,3 Holly Taylor,5 Bev Waterhouse,3 Louise Wills,9 Rebecca Woodhouse1 and Simon Gilbody1,7* 1Mental Healthand AddictionResearch Group, Department of HealthSciences, University ofYork, York, UK 2York Trials Unit, Department ofHealth Sciences, University ofYork, York, UK 3Epidemiology and Cancer Statistics Group, Department of HealthSciences, University of York, York, UK 4Northern Lincolnshire and Goole NHSFoundation Trust, ScunthorpeGeneral Hospital, Scunthorpe, UK 5Leeds andYork Partnership NHS FoundationTrust, Bootham ParkHospital, York, UK 6Department of Health Sciences, University of York, York, UK 7Hull YorkMedical School,York, UK 8Patient andpublic involvement representative, York, UK 9Harrogate and District NHS FoundationTrust, Harrogate District Hospital, Harrogate,UK *Corresponding author [email protected] Background: Perinatal depression iswell recognised asamental healthcondition but <50%ofcasesare identifiedinroutinepractice.Acase-findingstrategyusingtheWhooleyquestionsiscurrentlyrecommended bytheNationalInstituteforHealthandCareExcellence. Objectives: To determine thediagnostic accuracy, acceptability and cost-effectiveness ofthe Whooley questions and the Edinburgh PostnatalDepression Scale(EPDS) toidentify perinatal depression. Design: A prospective diagnostic accuracy cohort study, with concurrentqualitative andeconomic evaluations. Setting: Maternity services in England. Participants: Atotal of 391pregnant women. Main outcome measures:Women completed the Whooleyquestions, EPDSand adiagnostic reference standard(ClinicalInterviewSchedule–Revised)duringpregnancy(20weeks)andpostnatally(3–4months). Qualitativeinterviewswereconductedwithhealthprofessionals(HPs)andasubsampleofwomen. ©Queen’sPrinterandControllerofHMSO2018.ThisworkwasproducedbyLittlewoodetal.underthetermsofacommissioningcontractissuedbytheSecretaryofStatefor Health.Thisissuemaybefreelyreproducedforthepurposesofprivateresearchandstudyandextracts(orindeed,thefullreport)maybeincludedinprofessionaljournals vii providedthatsuitableacknowledgementismadeandthereproductionisnotassociatedwithanyformofadvertising.Applicationsforcommercialreproductionshouldbe addressedto:NIHRJournalsLibrary,NationalInstituteforHealthResearch,Evaluation,TrialsandStudiesCoordinatingCentre,AlphaHouse,UniversityofSouthamptonScience Park,SouthamptonSO167NS,UK.
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