Different cut-off points for different trimesters? the use of edinburgh postnatal depression scale and beck depression inventory to screen depression during pregnancy in Taiwan

Abstract

Background:Compared with postpartum depression, validating self-reported questionnaires to detect depression during pregnancy has gained much less attention. Furthermore, it is not known whether it is appropriate to use the same cut-off point to detect depression in different trimesters of pregnancy.Methods:One hundred and eighty-five Taiwanese women during pregnancy who completed the EPDS-T and the BDI-II were interviewed by psychiatrists with the structural interview, Mini-International Neuropsychiatric Interview (MINI), to establish DSM-IV diagnosis of major depressed disorder. We analyzed and compared the sensitivity, specificity, and validity of EPDS-T and the BDI-II against the MINI diagnosis in the second and third trimesters.Results:We identified 12/13 as the optimal cut-off of EPDS-T, at which the sensitivity of the scale was 83%, specificity 89%. The optimal cut-off of BDI-II was 11/12, at which the sensitivity of the scale was 74%, specificity 83%. The area under the curve (AUC) of the receiver-operating characteristic (ROC) analysis was 0.92 for EPDS-T and 0.84 for BDI. There were different optimal cut-off points of EPDS-T for detecting major depression during different trimesters: 13/14 for the second trimester and 12/13 for the third trimester. There was no different optimal cut-off point of BDI-II for different trimesters.Conclusions:EPDS-T has a satisfactory sensitivity and specificity, and a better validity than BDI-II for detecting major depressive disorder during pregnancy in Taiwanese pregnant women. Although it is possible that different cut-off points should be used to detect depression in different trimesters.