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Table 18-1

Recommended Psychiatric Assessments for OB/GYN Patients

Type of AssessmentDescription/Examples
Patient historyPrevious or current psychiatric symptoms, especially of mania/hypomania if depressive
Family history

  • Bipolar disorder (strong genetic component)

  • Completed or attempted suicide (increases patient risk)

Mental status examAppearance, orientation, speech, mood, suicidal thoughts, hallucinations, delusions, obsessions, compulsions, phobias
Screening for Psychiatric Conditions
Depression
AnytimePatient Health Questionnaire, 2 or 9 items (PHQ-2, PHQ-9)
Perinatal periodEdinburgh Postnatal Depression Scale (EPDS)
Bipolar disorderMood Disorder Questionnaire
Anxiety
Anytime

  • Generalized Anxiety Disorder 7-item scale (GAD-7)

  • Beck Anxiety Inventory (BAI)

Perinatal specific

  • Edinburgh Postnatal Depression Score—Anxiety (EPDS-A)a

  • Perinatal Anxiety Screening Scale (PASS)

  • Pregnancy-Related Anxiety Questionnaire–Revised (PRAQ-R)

Posttraumatic stress disorderPosttraumatic Stress Disorder Checklist (PCL-5)
Obsessive-compulsive disorderObsessive–Compulsive Inventory-Revised (OCI-R)
IPV

  • Hurt, Insult, Threaten, Scream (HITS), ACOG IPV Screening

  • Woman Abuse Screening Tool (WAST)

ACOG, American College of Obstetricians and Gynecologists; IPV, intimate partner violence.


aQuestions 3, 4, and 5 of the general Edinburgh Postnatal Depression Scale comprise a sub-scale to screen for perinatal-specific anxiety.