Accuracy of the Edinburgh Postnatal Depression Scale in screening for major depressive disorder and other psychiatric disorders in women towards the end of their puerperium


Authors: Horáková A. 1,2;  Nosková E. 1,3;  Švancer P. 1,3;  Marciánová V. 4;  Koliba P. 5;  Šebela A. 1,3
Authors place of work: Národní ústav duševního zdraví, Klecany 1;  Katedra psychologie, Filozofi cká fakulta, UK, Praha 2;  Klinika psychiatrie a lékařské psychologie 3. LF UK a NÚDZ, Praha 3;  Porodnicko-gynekologická klinika LF UP a FN Olomouc 4;  Gynekologicko-porodnická klinika 1. LF UK a FN Bulovka, Praha 5
Published in the journal: Ceska Gynekol 2022; 87(1): 19-26
Category: Původní práce
doi: 10.48095/cccg202219

Summary

Objective: To assess the accuracy of the Edinburgh Postnatal Depression Scale (EPDS) in screening for severe depression and other mental disorders in women at the end of puerperium. Materials and methods: We administered the Czech version of the EPDS to assess depressive symptoms and the Mini International Neuropsychiatric Interview to determine psychiatric dia­gnoses in 243 women at the end of their puerperium. Then, we determined the frequencies of severe depressive disorder and other psychiatric disorders in our cohort. Furthermore, we assessed the sensitivity, specificity, positive predictive value, negative predictive value, and other dia­gnostic variables for the presence of severe depression and other psychiatric disorders for different threshold scores on EPDS. We evaluated the detection potential of EPDS for detecting monitored mental disorders by using the receiver operating characteristic curve analysis and determining the area under the curve. Results: Severe depressive disorder was present in 2.5% (95% CI: 1.1–5.3%) of women. Any monitored mental disorder was present in 13.6% (95% CI: 9.8–18.5%). The best sensitivity/specificity ratio for detecting major depressive disorder was found for the EPDS threshold score ≥ 11; sensitivity was 83% (95% CI: 35–99%) and specificity was 79% (95% CI: 74–84%). The EPDS ≥ 11 then achieved a sensitivity of 76% (95% CI: 58–89%) and specificity of 82% (95% CI: 76–87%) for the detection of any mental disorder of interest. Conclusion: Our results showed that the Czech version of EPDS has good internal consistency, and the EPDS score ≥ 11 achieves the best combination of sensitivity and specificity values for detecting major depressive disorder. Screening with EPDS in women at the end of puerperium can detect psychiatric disorders other than severe major depression.

Keywords:

puerperium – postpartum depression – screening – Edinburgh postpartum depression scale – perinatal mental health


Zdroje

1. Ghaedrahmati M, Kazemi A, Kheirabadi G et al. Postpartum depression risk factors: a narrative review. J Educ Health Promot 2017; 6: 60. doi: 10.4103/jehp.jehp_9_16.

2. Sebela A, Byatt N, Formanek T et al. Prevalence of mental disorders and treatment gap among Czech women during paid maternity or parental leave. Arch Womens Ment Health 2021; 24 (2): 335–338. doi: 10.1007/s00737-020-01 052-w.

3. Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: a syste­matic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Front Psychiatry 2018; 8: 248. doi: 10.3389/fpsyt.2017.00 248.

4. Stein A, Pearson RM, Goodman SH et al. Effects of perinatal mental disorders on the fetus and child. Lancet 2014; 384 (9956): 1800–1819. doi: 10.1016/S0140-6736 (14) 61277-0.

5. Slomian J, Honvo G, Emonts P et al. Consequences of maternal postpartum depression: a systematic review of maternal and infant outcomes. Womens Health (Lond) 2019; 15: 1745506519844044. doi: 10.1177/174550651 9844044.

6. Sanger C, Iles JE, Andrew CS et al. Associations between postnatal maternal depression and psychological outcomes in adolescent offspring: a systematic review. Arch Womens Ment Health 2015; 18 (2): 147–162. doi: 10.1007/s00737-014-0463-2.

7. Levis B, Negeri Z, Sun Y et al. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ 2020; 371: m4022. doi: 10.1136/bmj.m4022.

8. Šebela A, Hanka J, Mohr P. Dia­gnostics and modern trends in therapy of postpartum depression. Ceska Gynekol 2019; 84 (1): 68–72.

9. Gibson J, McKenzie-McHarg K, Shakespeare J et al. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand 2009a; 119 (5): 350–364. doi: 10.1111/j.1600-0447.2009.01 363.x.

10. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782–786. doi: 10.1192/bjp.150.6.782.

11. Sheehan DV, Lecrubier Y, Sheehan KH et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured dia­gnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998; 59 (20): 22–33; quiz 34–57.

12. Winkler P, Formanek T, Mlada K et al. The CZEch mental health study (CZEMS): study rationale, design, and methods. Int J Methods Psychiatr Res 2018; 27 (3): e1728. doi: 10.1002/ mpr.1728.

13. Brown LD, Cai TT, DasGupta A. Interval estimation for a binomial proportion. Statist Sci 2001; 16 (2): 101–133. doi: 10.1214/ss/1009213 286.

14. Dušek L, Pavlík T, Jarkovský J et al. XXVI. Hodnocení dia­gnostických testů – věrohodnostní poměr a dia­gnostický poměr šancí. Cesk Slov Neurol N 2011; 74/107 (2): 221–225.

15. Shoaee F, Mohsenpour Z, Najarzadegan MR et al. Sensitivity and specificity of the Edinburgh Postnatal Depression Scale (EPDS) among Iranian mothers: a psychometric study. Systematic Review 2019; 7 (72): 10533–10540. doi: 10.22038/ijp.2019.44006.3653.

16. Venkatesh KK, Zlotnick C, Triche EW et al. Accuracy of brief screening tools for identifying postpartum depression among adolescent mothers. Pediatrics 2014; 133 (1): e45–e53. doi: 10.1542/peds.2013-1628.

17. Matijasevich A, Munhoz TN, Tavares BF et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) for screening of major depressive episode among adults from the general population. BMC Psychiatry 2014; 14: 284. doi: 10.1186/s12888-014-0284-x.

18. Meltzer-Brody S, Boschloo L, Jones I et al. The EPDS-Lifetime: assessment of lifetime pre­valence and risk factors for perinatal depression in a large cohort of depressed women. Arch Womens Ment Health 2013; 16 (6): 465–473. doi: 10.1007/s00737-013-0372-9.

19. Adewuya AO, Ola BA, Dada AO et al. Validation of the Edinburgh Postnatal Depression Scale as a screening tool for depression in late pregnancy among Nigerian women. J Psychosom Obstet Gynaecol 2006; 27 (4): 267–272. doi: 10.1080/01674820600915478.

20. Gibson J, McKenzie-McHarg K, Shakespeare J et al. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand 2009; 119 (5): 350–364. doi: 10.1111/j.1600-0447.2009.01363.x.

21. Gavin NI, Gaynes BN, Lohr KN et al. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005; 106 (5 Pt 1): 1071–1083. doi: 10.1097/01.AOG.0000183597. 31630.db.

22. Parsons CE, Young KS, Rochat TJ et al. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull 2012; 101: 57–79. doi: 10.1093/bmb/Idr047.

23. Lydsdottir LB, Howard LM, Olafsdottir H et al. The mental health characteristics of pregnant women with depressive symptoms identified by the Edinburgh Postnatal Depression Scale. J Clin Psychiatry 2014; 75 (04): 393–398. doi: 10.4088/JCP.13m08646.

24. Highet N. iCOPE: an innovative and effective approach to perinatal mental health screening in pregnant women and new mothers. Women and Birth 2017; 30 (Suppl 1): 12. doi: 10.1016/j.wombi.2017.08.032.

25. Kingston D, Austin MP, Veldhuyzen van Zanten S et al. Pregnant women’s views on the feasibility and acceptability of web-based mental health e-screening versus paper-based screening: a randomized controlled trial. J Med Internet Res 2017; 19 (4): e88. doi: 10.2196/jmir. 6866.

26. Simas TA, Flynn MP, Kroll-Desrosiers AR et al. Systematic review of integrated care interventions addressing perinatal depression care in ambulatory obstetric care settings. Clin Obstet Gynecol 2018; 61 (3): 573–590. doi: 10.1097/GRF.0000000000000360.

27. Lomonaco-Haycraft KC, Hyer J, Tibbits B et al. Integrated perinatal mental health care: a national model of perinatal primary care in vulnerable populations. Prim Health Care Res 2018; 20: e77. doi: 10.1017/S1463423618000 348.

28. Byatt N, Xu W, Levin LL et al. Perinatal depression care pathway for obstetric settings. Int Rev Psychiatry 2019; 31 (3): 210–228. doi: 10.1080/09540261.2018.1534725.

29. Šebela A, Hanka J, Mohr P. Etiology, risk factors, and methods of postpartum depression prevention. Ceska Gynekol 2018; 83 (6):  468–473.

Štítky
Dětská gynekologie Gynekologie a porodnictví Reprodukční medicína

Článek vyšel v časopise

Česká gynekologie

Číslo 1

2022 Číslo 1

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