Depressive symptomatology during pregnancy and the postpartum period: Is the beck depression inventory applicable?

Abstract

The Beck Depression Inventory (BDI), a widely used tool to assess depression during pregnancy and the postpartum period, has some item heterogeneity and contains some items that may be normative during pregnancy rather than uniquely indicative of depression. To evaluate the implications of this, we studied 62 primiparous women and a comparison group of 36 nulliparous women. Assessments were made at the 31st week of pregnancy and 12 weeks postpartum in the pregnant group, as well as at similar intervals in the nonpregnant group. The BDIitems were divided into two conceptually based clusters: Cognitive-Affective and Somatic. A third cluster was designated Residual. This conceptual grouping was supported by moderately high alpha coefficients and low intercorrelations between clusters. The total BDI and the clusters were then evaluated longitudinally in two analyses: (1) pregnant and nonpregnant women with low psychiatric risk were compared, and (2) pregnant women of low and high psychiatric risk were compared. The results indicated that the clusters illuminated differential patterns of change that were obscured in the total BDI. The Cognitive-Affective cluster appears most sensitive to ‘true’ depression during pregnancy. For this cluster, pregnant women with low psychiatric risk had scores that were comparable to nonpregnant women; additionally, mothers of high psychiatric risk showed elevated scores in the postpartum period compared with mothers of low psychiatric risk. For mothers, scores on the Somatic and Residual clusters declined in the postpartum period, independently of psychiatric risk. This patterns are conceptually meaningful and contrast with the picture that emerged with total BDI scores.