Validation of the Edinburgh Postnatal Depression Scale (EPDS) in a sample of mothers from the 2004 Pelotas Birth Cohort Study

Cadernos de Saude Publica - Tập 23 Số 11 - Trang 2577-2588 - 2007
Iná S. Santos1, Alícia Matijasevich1, Beatriz Tavares1, Aluísio J. D. Barros1, Iara Picinini Botelho1, Catherine Lapolli1, Pedro Vieira da Silva Magalhães2, Ana Paula Pereira Neto Barbosa1, Fernando C. Barros3
1Universidade Federal de Pelotas, Brasil
2Universidade Católica de Pelotas, Brasil
3Organización Mundial de la Salud, Uruguay

Tóm tắt

The aim of this study was to evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening and diagnosis of postpartum depression. Three months after delivery, EPDS was administered to 378 mothers from the 2004 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil. Up to 15 days later, mothers were re-interviewed by mental health care professionals using a semi-structured interview based on ICD-10 (gold standard). We calculated the sensitivity and specificity of each cutoff point, and values were plotted as a receiver operator characteristic curve. The best cutoff point for screening postpartum depression was > 10, with 82.6% (75.3-89.9%) sensitivity and 65.4% (59.8-71.1%) specificity. For screening moderate and severe cases, the best cutoff point was > 11, with 83.8% (73.4-91.3%) sensitivity and 74.7% (69.4-79.5%) specificity. For diagnosis, EPDS was valid only for prevalence of postpartum depression in the 20-25% range, with 60% PPV for the > 13 cutoff point (59.5% sensitivity; 88.4% specificity). The specificities and PPVs for all cutoff points were below those reported by other authors. Small numbers and the calculation of PPV in samples with overrepresentation of cases in the majority of studies appear to account for these differences.

Từ khóa


Tài liệu tham khảo

Buist AE, 2002, To screen or not to screen - that is the question in perinatal depression, Med J Aust, 177 Suppl, S101

Beck CT, 1993, Teetering on the edge: a substantive theory of postpartum depression, Nurs Res, 42, 42

Beck CT, 1995, The effects of postpartum depression on maternal-infant interaction: a meta-analysis, Nurs Res, 44, 298

Cogil SR, 1986, Impact of maternal postnatal depression on cognitive development of young children, BMJ, 292, 1165, 10.1136/bmj.292.6529.1165

Holden JM, 1991, Postnatal depression: its nature, effects, and identification using the Edinburgh Postnatal Depression Scale, Birth, 18, 211, 10.1111/j.1523-536X.1991.tb00104.x

Murray J, 1991, The impact of postnatal depression on infant development, J Child Psychol Psychiatr, 33, 543, 10.1111/j.1469-7610.1992.tb00890.x

Stein A, 1992, The relationship between post-natal depression and mother-child interactions, Br J Psychiatry, 158, 46, 10.1192/bjp.158.1.46

Cox JL, 1992, A controlled study of the onset, duration, and prevalence of postnatal depression, Br J Psychiatry, 163, 27, 10.1192/bjp.163.1.27

Garcia-Esteve L, 2003, Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers, J Affect Disord, 75, 71, 10.1016/S0165-0327(02)00020-4

Sword W, 2000, New mothers identify information needs: actions for postpartum community care providers, Public Health and Epidemiology Report Ontario, 11, 38

Gotlib IH, 1989, Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum, J Consult Clin Psychol, 57, 269, 10.1037/0022-006X.57.2.269

O'Hara MW, 1990, Controlled prospective study of mood disorders: comparison of childbearing and nonchildbearing women, J Abnorm Psychol, 99, 3, 10.1037/0021-843X.99.1.3

Warner R, 1996, Demographic and obstetric risk factors for postnatal psychiatric morbidity, Br J Psychiatry, 168, 607, 10.1192/bjp.168.5.607

Watt S, 2002, A cross-sectional study of early identification of postpartum depression: implications for primary care providers from The Ontario Mother & Infant Survey, BMC Fam Pract, 11, 3

Uwakwe R, 2003, Affective (depressive) morbidity in puerperal Nigerian women: validation of the Edinburgh Postnatal Depression Scale, Acta Psychiatr Scand, 107, 251, 10.1034/j.1600-0447.2003.02477.x

Cox JL, 1987, Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale, Br J Psychiatry, 150, 782, 10.1192/bjp.150.6.782

Barros FC, 2005, The challenge of reducing neonatal mortality in middle-income countries: findings from three Brazilian birth cohorts in 1982, 1993, and 2004, Lancet, 365, 847, 10.1016/S0140-6736(05)71042-4

Da Silva VA, 1998, Prenatal and postnatal depression among low-income Brazilian women, Braz J Med Biol Res, 31, 799, 10.1590/S0100-879X1998000600012

1998

Eberhard-Gran M, 2001, Review of validation studies of the Edinburgh Postnatal Depression Scale, Acta Psychiatr Scand, 104, 243, 10.1034/j.1600-0447.2001.00187.x

Santos MFS, 1999, Escala de auto-avaliação de depressão pós-parto: estudo no Brasil, Rev Psiquiatr Clin, 26, 90

Fletcher RH, 1996

Lijmer JG, 1999, Empirical evidence of design-related bias in studies of diagnostic tests, JAMA, 282, 1061, 10.1001/jama.282.11.1061

Rutjes AW, 2006, Evidence of bias and variation in diagnostic accuracy studies, CMAJ, 174, 469, 10.1503/cmaj.050090

Blenning CE, 2005, An approach to the postpartum office visit, Am Fam Physician, 72, 2491

Thông tin
Thông tin xuất bản

Cadernos de Saude Publica

Tập 23 Số 11

2577-2588

Thông tin tác giả