Dimensions of Depressive Symptoms of Chinese Postpartum Mothers

Ching-Yu Cheng

doi:10.15344/2394-4978/2014/104

Abstract

Background: The Center for Epidemiologic Studies Depression (CESD) scale, which includes both somatic and psychosocial measurements, has been widely used to measure depression; however, its use in measuring postpartum depression was limited. The purpose of the study was to test reliability and validity of the Chinese CESD when used on Chinese postpartum mothers. Dimension of depressive symptoms of Chinese postpartum mothers was analyzed as well. Methods: The study used a cross-sectional correlational design and included a pilot and a main study. Thirty Chinese postpartum mothers participated in the pilot study, which tested the readability and content validity of the Chinese CESD. Data from 120 Chinese postpartum mothers living in the United States were analyzed in the main study. Most mothers were homemakers, highly educated, primiparous, and gave birth vaginally. Instruments used included the Chinese CESD, mentally unhealthy days, and postpartum feelings. Cronbach's alpha, Pearson correlation, and confirmatory factor analysis were applied to test the reliability and validity of the Chinese CESD. Results: Cronbach’s alpha for the Chinese CESD was .89. The convergent and divergent validities of the Chinese CESD were supported. Confirmatory factor analysis showed a three-factor model (Somatic Symptoms/Depressed Affect, Positive Affect, and Interpersonal Problems/Depressed) fit better with the data. The three factors correlated with each other (r ranged from .59 to .71). Conclusion: The Chinese CESD was a reliable and valid instrument for measuring depressive symptoms in Chinese postpartum mothers. Instead of reporting depressed affect, Chinese mothers tend to report physical and interpersonal problems. Healthcare professionals taking care of Chinese postpartum mothers are suggested to assess their common physical conditions as well. Future studies are recommended to include larger samples and focus on relationships between physical symptoms and depression. Comparisons of models for postpartum depression among mothers of diverse ethnicities can increase our knowledge about postpartum depression.

Highlights

Postpartum depression among chinese mothersDifferent instruments have been applied to assess postpartum depression among Chinese mothers
Using other screening tools for postpartum depressive symptoms, the rate varied widely depending on what instrument was used and where
The Center for Epidemiologic Studies Depression (CESD) was piloted with 30 Chinese postpartum mothers

Summary

Introduction

Different instruments have been applied to assess postpartum depression among Chinese mothers (including Chinese descent women in China, Taiwan, and Hong Kong). Using the Diagnostic and Statistical Manual of Mental Disorders (DSM) or Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the prevalence for postpartum depression was as high as 15.7% [4]. Using other screening tools (i.e. the Edinburgh Postnatal Depression Scale [EPDS], Beck Depression Inventory [BDI], CESD, and 12-item General Health Questionnaire [GHQ-12]) for postpartum depressive symptoms, the rate varied widely depending on what instrument was used and where. Int J Nurs Clin Pract ISSN: 2394-4978 Using the GHQ-12, the rate was 32% in Hong Kong [5]; when using the CESD, the rate was 35.3% in Taiwan [6]; when using the BDI, the rate was 50.2% in Taiwan [7]; and when using the EPDS, the rate was 28.8% in Taiwan [8] and was 4.7% in Mainland China [9]

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