Effectiveness of Measuring Women's Postpartum Mental Health With a Subjective Psychological Well-Being Scale

Depression and anxiety affect about one in five women during pregnancy or after birth, yet many are never identified early enough to receive support. Because some women may hesitate to report symptoms directly, clinicians are encouraged to assess overall well‑being instead of mental health symptoms only. We examined whether a well‑being screening tool—the WHO‑5—can reliably identify women with probable postpartum depression or anxiety compared with two validated symptom‑based tools: the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder Scale (GAD‑7). We used data from a trial of 510 women in Quebec who reported significant depressive symptoms during pregnancy. At three months postpartum, 16% screened positive for depression on the EPDS and 22% for anxiety on the GAD‑7. We compared WHO‑5 scores with each tool and estimated how often the WHO‑5 incorrectly classified women as having probable depression or anxiety. False‑positive rates were high: 64–70% for depression and 63–69% for anxiety. Thus, the WHO‑5 does not reliably identify postpartum depression or anxiety and might substantially overrate women as needing follow‑up assessment. Symptom‑based perinatal‑validated toolssuch as the EPDS and GAD‑7 remain more accurate for early detection in postpartum care.(Comprehensive lay and technical summaries are available in the full‑text)