Development and validation of a multidimensional mental health screening questionnaire for pregnant women: A preliminary report

Background: Mental health problems during pregnancy are multifaceted major health issues.

Aim: To develop and validate a short screening questionnaire that covers important domains including antenatal depression, tokophobia, fetal bonding disorder, suicidality, and emesis.

Methods: A total of 321 pregnant women who were less than 36 weeks gestation responded to a cross-sectional web survey and filled in the 33-item Dimensional Assessment of Mother Baby Organization Questionnaire (DAMBO Q33, available as an e-book). Out of these women, 111 (35%) responded to our invitation to an online research interview (Dimensional Assessment of Mother Baby Organization-Research Version). Using theory-driven or cluster analysis-driven categories of the five mental health domains as a gold standard, we identified the most powerful DAMBO Q33 questionnaire items for each domain and calculated psychometric properties of cut-off points of the domain scores for the questionnaire, including sensitivity, specificity, and positive and negative predictive values. We proposed the best cut-off value for each domain.

Results: We identified 11 DAMBO Q33 items as the best predictors for five mental health domains. The psychometric properties of the best cut-off points were acceptable for each domain. By these cut-off points, we could identify 57%, 19%, 100%, 46%, and 46% of true cases of antenatal depression, tokophobia, fetal bonding disorder, suicidality, and emesis, respectively. Positive cases of the five domains substantially coexisted with each other.

Conclusion: The final 11-item questionnaire (DAMBO Q11) may be a useful screening tool for the five major mental health problems among pregnant women.