Although postpartum depression is not uncommon among new mothers, it often goes undetected. This item, self-report instrument can be administered in just 5 to 10 minutes. Used as a brief screening device, it identifies women who are at high risk for postpartum depression, so that health care professionals can then refer them for definitive diagnosis and treatment. Written at a third-grade reading level, PDSS items are brief and easy to understand. Normal adjustment Significant symptoms of postpartum depression Positive screen for major postpartum depression.
An Inconsistent Responding Index is also included to measure response validity. Standardization is based on two samples: new mothers of various ethnic backgrounds and women recruited through childbirth classes and newspaper ads prior to giving birth.
The first seven items on the scale can function as a Short Form. The PDSS can be used across various specialties, including obstetrics, pediatrics, psychiatry, psychology, and social work. It can be administered as early as 2 weeks after delivery. In addition to indicating which mothers need to be referred for a complete diagnostic work-up and treatment, the scale guides and informs treatment by means of the symptom profile it produces. And its brevity and economy make the PDSS ideal for monitoring treatment response.
Given the high incidence of postpartum depression, the current low rate of detection, and the potentially serious consequences, the PDSS is extremely useful in identifying women who need focused attention from mental health professionals. In the other 16, 3 had alcohol and drug dependence diagnoses and 13 had no current or past psychiatric disorders.
The AUCs for the three scales dichotomized at the chosen cutoff points are shown in Table 4. At baseline, 34 women also completed the additional 28 items on the PDSS.
With the imputed data, we also found the cutoff points for each of the scales that maximized the AUCs possible if three categories of risk for MDD were used. Figure 2 shows graphically the increase in AUCs if three group rather than two group categorization is used to identify women at risk for MDD in the first 6 months postpartum. Women were willing to participate by telephone and home visits.
We found no significant differences in sociodemographic characteristics of women whom we were and were not able to contact. Scores on the three continuous measures were highly correlated. Some of our findings are contrary to those reported; others are equivalent. Correlations between the short and complete forms of the PDSS are 0. Differences between the reported accuracy of the PHQ-9 in Kroenke et al. The EPDS has several advantages. It consists of only 10 items and can be administered in a short period, it can be used free of charge by investigators, it has been translated into 23 languages, and it has been used in various socioeconomic and ethnic groups.
The primary focus on screening, however, is to identify women at high risk and provide support to seek or continue treatment. Our study suggests that the EPDS accurately identifies women who are depressed or will experience depression in the first 6 months postpartum.
Our analyses of continuous screening scores for all instruments indicated that the three measures were equivalently accurate. This suggests that any of these measures is useful for placing women in order of increasing risk for MDD.
We did not find that using more than one screening measure led to more accurate identification than using one of the measures with an appropriate cutoff point.
Based on our imputed data, splitting each of the measures into three categories, no risk, elevated risk, and high risk for MDD, would increase the diagnostic capacity of all of the measures. Women with the highest scores have a higher risk of current MDD and should be referred for treatment; women with the moderate scores have an elevated risk of MDD, but watchful waiting with further screening and psycho-education may be most appropriate and cost-effective.
Our results raise concerns about using the PHQ-9 as a screen for postpartum depression because of its accuracy. However, the accuracy of this measure with a lower cutoff point and three categories is as high as that of the other measures.
Our study had several limitations that affect its generalizability. The data were collected from a small sample of women who delivered within the same insurance plan. Although we cast a wide net and administered the DIS to any participant who had a positive result on any of the tests, we were not able to administer the DIS to those with negative screening test results.
This method of interviewing only women with high symptoms is widely used 1 and cost-effective. Our novel use of simulated data, which was used to address this limitation, provided a clear indication that the EPDS and PDSS are more appropriate instruments to use to identify MDD in the postpartum period.
Finally, we did not administer the screening tests in random order. Since we collected our data, Mitchell et al. Pinto-Meza et al. Rescreening done at 3 and 6 months was accepted by all women reached. Our conclusion was that very few postpartum women who were expecting a call to screen for depression refused to be screened and very few refused subsequent calls.
Telephone screening for postpartum depression at 6—8 weeks postpartum is a time-efficient, well-received method of identifying women at risk for MDD. Screening is only the first step in the recovery process; subsequent work must focus on finding appropriate and acceptable treatment strategies for this vulnerable population. As more local, state, 30 national, and international agencies target the impact of postpartum depression on women, children, families, employers, and the larger society for intervention, widespread screening is likely to be implemented.
We acknowledge the contribution of Christopher R. Hanusa, Ph. No pharmaceutical companies were involved in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.
National Center for Biotechnology Information , U. J Womens Health Larchmt. Author manuscript; available in PMC Mar Author information Copyright and License information Disclaimer. Address reprint requests to: Barbara H. Copyright notice. The publisher's final edited version of this article is available at J Womens Health Larchmt.
See other articles in PMC that cite the published article. Abstract Objectives: Postpartum depression, the most prevalent complication of childbirth, is often unrecognized.
Conclusions: Administering the EPDS by phone at 6—8 weeks postpartum is an efficient and accurate way to identify women at high risk for postpartum depression within the first 6 months after delivery. Study instruments and scores The item EPDS is the instrument most commonly used to screen for postpartum depression. Home visit criteria. Statistical analysis We used descriptive statistics to characterize study participants in terms of sociodemographic and health-related data, screening results, and DIS results.
Verification bias. Secondary aims. Open in a separate window. Table 1. Participant characteristics Women in the study had a mean age of Table 2. Characteristics and results of tests Table 3 shows the results from the 29 women who completed the three screening instruments and the DIS 27 at 6—8 weeks after delivery, 1 at 3 months, and 1 at 6 months.
Primary care screening for and treatment of depression in pregnant and postpartum women: evidence report and systematic review for the US Preventive Services Task Force. The purpose of this study was to develop a new, brief screening measure to identify postpartum distress, defined as symptoms of depression and anxiety. Clinicians are free to use it to get a sense of a constellation of symptoms. The prevalence of Postpartum Depression — measured by the Edinburgh Postnatal Depression Scale — at four months after delivery was British Journal of Psychiatry.
Reprinted with permission. The purpose of the study was to analyse for the first time the validity of a slightly modified version of the Portuguese Postpartum Depression Screening Scale PDSS , to be used as a screening instrument for antenatal depression. This illness has potentially devastating consequences for both mother and infant, and is thought to be highly underreported and under-diagnosed. This is a item questionnaire which has been validated in many different populations and is available in almost every language.
On this scale, a score of 10 or greater or an affirmative answer … Examines the the Edinburgh Postnatal Depression Scale EPDS which is widely used to screen women for postpartum depression, and concludes that it may not be an equally valid screening tool across all settings and contexts.
General depression screening tools have also been used to screen for PPD in new mothers. Identifies women who are at high risk for postpartum depression so that they can be referred for definitive diagnosis and treatment. The purpose of this study was to further assess measures of validity for the Postpartum Depression Screening Scale PDSS - Spanish Version on sensitivity, specificity, and predictive values. In the postpartum period, the EPDS has been the most widely used scale to identify postpartum depression.
It was developed to assist health professionals to screen community samples of postnatal mothers for depressive symptoms following childbirth and has been extensively studied and used in a Screening for Perinatal Depression.
ABSTRACT: Perinatal depression, which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery, is one of the most common medical complications during pregnancy and the postpartum period, affecting one in … The translation and validation of the Postpartum Depression Screening Scale PDSS : towards improving screening for postpartum depression in English- and Afrikaans-.
Postpartum Depression Screening Tools The Edinburgh Postnatal Depression Scale EPDS is a set of 10 screening questions that can indicate whether a parent has symptoms that are common in women with depression and anxiety during pregnancy and in the year following the birth of a child.
The EPDS consists of a scale of 10 items, each with four possible responses from 0 to 3, which express the intensity of depressive symptoms over the 7 days preceding the interview. The Postpartum Depression Screening Scale PDSS was created specifically for postpartum women and is a item, self-report questionnaire which about 5 to 10 minutes to complete.
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