Susan M. Blake, PhD¹, Kathy S. Katz, PhD², K.N. Siva Subramanian, MD³, Deborah A. Schwartz, MPH⁴, and M. Nabil El-Khorazaty, PhD⁴. (1) Prevention and Community Health, George Washington University, 2175 K St NW, Suite 700, Washington, DC 20037, 202-253-4275, smblake1@aol.com, (2) Pediatrics, Georgetown University Medical Center, 3800 Reservoir RD NW, Kober Cogan 414, Washington, DC 20007, (3) Georgetown University, 3800 Reservoir Road, NW, 3 Main Hospital, M-3400, Washington, DC 20007, (4) RTI International, 6110 Executive Blvd., Suite 420, Rockville, MD 20852

Background: Pregnant, low income minority women show high rates of undisclosed depression. The prenatal period is an opportune time for intervention. Improved identification in primary care would enhance opportunities for treatment of depression. Brief, reliable assessment measures are needed to identify depression in clinical settings.

Methods: This study evaluated the concordance of positive screening for depression by the BDI FastScreen(BDI-FS) for Medical Patients and the Hopkins Symptom Checklist Depression Scale-20 (HSCL-20), two measures that have been used for screening in primary care.

Subjects: Subjects were 863 low income African American women enrolled in prenatal care clinics in Washington, DC and participating in a prenatal intervention study, the NIH-DC Initiative to Reduce Infant Mortality.

Results: The concordance coefficient for the 2 measures was 0.48. The BDI-FS found 37% of the sample to have depression and the HSCL-20 45%. Women depressed on both measures were more likely to: currently smoke cigarettes, be unhappy with their pregnancy, and have lower levels of social support. Among those women discordant between the 2 measures, those screened positive on the BDI-FS were more likely to be without a current partner, to have 3 or more children, to be receiving some form of public assistance, and to smoke during pregnancy.

Conclusions: The BDI-FS and the HSCL-D-20 show moderate concordance in screening for depression in pregnant minority women. Further item analysis is planned to identify the patterns of divergence. The BDI-FS appears the more conservative scale, but identifies depressive symptomatology in a particularly high risk underserved population.

Learning Objectives:

1.Participants will be able to recognize symptoms of depression in pregnant women.
• Participants will be able to assess strategies for identifying depression in primary care 3.Participants will be able to evaluate 2 tools for screening for depression.

Keywords: Depression, Primary Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.