Determining cut-off points of the DASS-21 scale for screening depression, anxiety, and stress symptoms during pregnancy

Abstract

Pregnancy is a moment of vulnerability when physical and emotional changes can result in symptoms of anxiety, stress, or depression. Although negative emotional states represent risks for adverse outcomes for mother and baby, instruments for their early identification and prevention are scarce. The study aims to examine the validity of the DASS-21 scale among pregnant Brazilian women and determine an optimal cut-off point for screening anxiety, depression, and stress during pregnancy. Receiver Operating Characteristic curve analysis was conducted with data collected from 378 women that answered the DASS-21, and the BDI, BAI, and LSSI as gold standard measurements. Area Under the Curve, sensitivity and specificity were analyzed for each trimester of gestation to suggest clinical cut-off points. All AUC values were higher than 0.80, and the sensitivity and specificity indexes were between 74.36 and 51.65, respectively. These findings suggest that the DASS-21 is a viable measure of screening among pregnant women