Validating the Edinburgh Postnatal Depression Scale as a screening tool for postpartum depression in Kathmandu, Nepal.

Nisha Bhandari,Tania Gavidia,Babu Ram Bhusal,Manisha Chapagai

doi:10.1186/s13033-016-0102-6

Abstract

BackgroundEdinburgh Postnatal Depression Scale (EPDS) is considered well accepted screening tool for postpartum depression (PPD). The objective of the study was to validate the EPDS as a screening tool for postpartum depression in Kathmandu, Nepal.MethodsA hospital based cross sectional study using EPDS was conducted among 346 mothers between 4 and 14 weeks of postpartum period. All the participants were examined by psychiatrist for possible clinical PPD diagnosis using International Classification of Disease tenth revision (ICD-10). Sensitivity, specificity, positive predictive value and negative predictive value were calculated for validation of EPDS. The best cut off point for Nepalese version of EPDS was identified and area of the receiver operating characteristics curve was calculated.ResultsThe overall prevalence of PPD was 17.1 %.The sensitivity, specificity, positive predictive value and negative predictive value of the Nepalese version EPDS was found to be 92, 95.6, 77 and 99.3 % respectively. The best cut-off point of EPDS for screening of PPD was found to be 12/13 and the area of the curve was 0.98 (95 % CI 0.970–0.994, p = 0.001).ConclusionsThe prevalence of PPD is not that far from the previous studies of Nepal. Nepali version of EPDS was acceptable and the study demonstrates good validity, thus EPDS can be used as valid screening tool for PPD for early detection, prompt treatment and to prevent possible consequences.

Highlights

Edinburgh Postnatal Depression Scale (EPDS) is considered well accepted screening tool for postpartum depression (PPD)
Postpartum depression is defined as an episode of nonpsychotic depression according to standardized diagnostic criteria with onset within 1 year of childbirth [1]
As there is wide variation in sensitivity of EPDS in various validation studies conducted in Nepal, this study aimed to validate original English version of EPDS into Nepali version in order to measure the accuracy of the EPDS to screen postpartum depressive symptoms

Summary

Introduction

Edinburgh Postnatal Depression Scale (EPDS) is considered well accepted screening tool for postpartum depression (PPD). The objective of the study was to validate the EPDS as a screening tool for postpartum depression in Kathmandu, Nepal. The. Postpartum Depression can have several consequences which includes maternal death due to suicide [17], the Bhusal et al Int J Ment Health Syst (2016) 10:71 mother infant relationship [18], psychological development of child [19], infant nutrition [20] and infant growth [21]. The effects of postnatal depression on the mother, her marital relationship, and her children make it an important condition to diagnose, treat and prevent [1]

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Conclusion