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Table 3 Criteria for ‘high risk’ and referral to physician

From: Study protocol for a randomized, controlled, superiority trial comparing the clinical and cost- effectiveness of integrated online mental health assessment-referral-care in pregnancy to usual prenatal care on prenatal and postnatal mental health and infant health and development: the Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT)

Based on baseline DASS21/EPDS

Based on ‘unsuitability’ for CBT (intervention group)

Women with ‘severe’ or ‘extremely severe’ psychological distress based on one or more of the following criteria:

Women in intervention group with three or more of the following criteria:

1. Depression subscale ≥21 and/or

1. ANRQ-R positive for childhood emotional neglect, childhood emotional abuse, or childhood sexual or physical abuse and/or

2. Anxiety subscale ≥15 and/or

2. ANRQ-R positive for multiple major stressors (for example, major financial issues, bereavement, or separation)

3. Stress subscale ≥26

3. Current substance use or domestic violence

4. EPDS positive Q10 (1, 2, or 3)

4. EPDS positive Q10 or total EPDS score >15

  1. ANRQ-R, Antenatal Risk Questionnaire-Revised; CBT, cognitive behavior therapy; DASS21, Depression, Anxiety, Stress Scale 21; EPDS, Edinburgh Postnatal Depression Scale.