However, for 10-15 percent of pregnant women, depressive symptoms can spiral into a full-blown diagnostic depression, which can start in any trimester.
In this respect also it is important to acknowledge that the GHQ is a general measure of mental health and it is not a measure of diagnostic depression.
People with diagnostic depression have increased levels of inflammation (51), and psychological stresses have been shown to activate the innate inflammatory response with chronic cytokinaemia leading to IR and β-cell apoptosis, antecedents to the development of T2DM (52).
In Figure 3 we also superimposed the cutoffs (vertical lines; solid lines for females, dashed lines for male s) that distinguish the diagnostic depression levels (to be explained below).
Routine screening (better if using multiple screening tools including a diagnostic depression screen), evaluation, and treatment are strongly recommended since these women are unlikely to receive treatment or supportive counseling at routine outpatient clinics.
The estimated percentages of adolescents in the population sample who had been in contact with helping agencies because of mental health problems, either currently or lifetime in the different diagnostic depression groups are presented in table 6.
