Validation of the Leverton Questionnaire as a screening tool for postnatal depression in Hungary

Abstract

Objective To assess the validity of the 24-item Leverton Questionnaire (LQ) in screening for postnatal depression (PND). Method A two-phase, cross-sectional study was designed. Between January and October 2006, a sample of 1552 women attending a routine postnatal check-up at 6 weeks postpartum completed the LQ in southeast Hungary. On the basis of the LQ total score, the participants were stratified and randomly selected within each stratum for clinical evaluation (Structured Clinical Interview for DSM-IV). Receiver operating characteristic (ROC) analyses were used to examine the sensitivity and specificity of the LQ to detect PND. Results The best cut-off on the Hungarian version of the LQ for PND was 11/12, with a sensitivity of 88.0%, and a specificity of 94.4%, and a positive predictive value of 53.1%. Internal consistency was satisfactory (Cronbach α coefficients ≥0.753). The sensitivity of the modified Beck Depression Inventory (BDI) in detecting PND was 86.2% and the specificity 90.4%. Although the BDI performed slightly better than the LQ in distinguishing between minor and major depression, both psychometric scales showed satisfactory screening performance. Conclusions Our data confirm the validity of the Hungarian version of the LQ reliably to identify PND. We propose a cut-off of 11/12 for screening purposes for PND, the range of 11–14 for detecting minor depression and regarding a total score of 15 points or above as indicative of major depression.