Original Research

Validation of the Whooley questions for antenatal depression and anxiety among low-income women in urban South Africa

Carina Marsay, Lenore Manderson, Ugasvaree Subramaney
South African Journal of Psychiatry | Vol 23 | a1013 | DOI: https://doi.org/10.4102/sajpsychiatry.v23i0.1013 | © 2017 Carina Marsay, Lenore Manderson, Ugasvaree Subramaney | This work is licensed under CC Attribution 4.0
Submitted: 02 June 2016 | Published: 11 April 2017

About the author(s)

Carina Marsay, Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
Lenore Manderson, School of Public Health, University of the Witwatersrand,, South Africa
Ugasvaree Subramaney, Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa and Sterkfontein Hospital, South Africa

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Background/objective: In South Africa, approximately 40% of women suffer from depression during pregnancy. Although perinatal depression and anxiety are significant public health problems impacting maternal and infant morbidity and mortality, no routine mental health screening programmes exist in the country. A practical, accurate screening tool is needed to identify cases in these busy, resource-scarce settings.

Method: A convenience sample of 145 women between 22 and 28 weeks gestation was recruited from Rahima Moosa Hospital antenatal clinic in Johannesburg. All women completed a biographical interview, the Edinburgh Postnatal Depression Scale (EPDS), the Whooley questions and a structured clinical interview.

Results: The results demonstrate the sensitivity and specificity of the Whooley questions and the EPDS in identifying depression, anxiety and stress disorders of varying severity. The importance of personal, social and cultural context in influencing the content and expression of these common perinatal conditions was also identified.

Discussion and conclusion: The validity of the Whooley questions in the context of urban South Africa, and the importance of ensuring clinical interviews to supplement any screening tools, is emphasised.


perinatal depression; screening; South Africa


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Crossref Citations

1. Comparison of mental health screening tools for detecting antenatal depression and anxiety disorders in South African women
Thandi van Heyningen, Simone Honikman, Mark Tomlinson, Sally Field, Landon Myer, Phillipa J. Hay
PLOS ONE  vol: 13  issue: 4  first page: e0193697  year: 2018  
doi: 10.1371/journal.pone.0193697