Validating the Edinburgh Postnatal Depression Scale Against the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition for Use in Uganda.

Journal: International journal of women's health

Volume: 15

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda. Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda. Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda. Department of Obstetrics & Gynaecology, Mbarara University of Science and Technology, Mbarara, Uganda. SOAR Research Foundation, Mbarara, Uganda. Division of Infectious Diseases and Center for Global Health Massachusetts General Hospital, Boston, MA, USA. Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.

Abstract summary 

The Edinburgh Postnatal Depression Scale (EPDS) is a widely acknowledged screening tool for postpartum depression (PPD) globally, but its validation in Uganda has been lacking. This study aimed to assess the EPDS's accuracy as a PPD screening tool in Uganda compared to the Mini-International Neuropsychiatric Interview (MINI 7.0.2) based on the DSM-5.This was a descriptive cross-sectional study conducted at a referral hospital and two peri-urban primary care postpartum clinics in rural southwestern Uganda. We enrolled 287 mothers aged 18 to 49 at their six-week postpartum visit. The EPDS was used for initial screening, and the MINI 7.0.2 was employed for clinical diagnosis. The study used the Runyankore-Rukiga language version of the EPDS and collected data from November 11, 2019, to June 10, 2020, with the MINI 7.0.2 as the reference standard.The overall PPD prevalence was 29.5%, as opposed to 26.5% with EPDS and MINI 7.0.2 DSM-5 criteria (p = 0.239). The EPDS demonstrated a sensitivity of 86.8%, specificity of 92.1%, positive predictive value of 80.5%, and negative predictive value of 94.9%. A cutoff score of ≥10 was found to be the most effective acceptable point after drawing the AUC of ROC and determining the most appropriate point using Youden's index. The area under the ROC curve, indicating the scale's overall performance against MINI 7.0.2, was 0.89 for Bwizibwera HCIV, 0.97 for Kinoni HCIV, and 0.84 for MRRH. In conclusion, the EPDS can effectively screen for postpartum depression in southwestern Uganda using a cutoff score of ≥10. It exhibits strong diagnostic performance in correctly identifying PPD in postpartum mothers.

Authors & Co-authors:  Atuhaire Catherine C Brennaman Laura L Nambozi Grace G Taseera Kabanda K Atukunda Esther C EC Ngonzi Joseph J Atwine Daniel D Matthews Lynn T LT Rukundo Godfrey Zari GZ

Study Outcome 

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Statistics
Citations :  Letourneau NL, Dennis C-L, Benzies K, et al. Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children. Issues Ment Health Nurs. 2012;33(7):445–457. doi:10.3109/01612840.2012.673054
Authors :  9
Identifiers
Doi : 10.2147/IJWH.S427752
SSN : 1179-1411
Study Population
Mothers
Mesh Terms
Other Terms
DSM-5;EPDS;MINI;postpartum depression;validation
Study Design
Descriptive Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
New Zealand