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Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale.
J Affect Disord. 2008 Jun; 108(3):251-62.JA

Abstract

BACKGROUND

The cultural validity of instruments to detect perinatal common mental disorders (CMD) in rural, community settings has been little-investigated in developing countries.

METHODS

Semantic, content, technical, criterion and construct validity of the Edinburgh Postnatal Depression Scale (EPDS) and Self-Reporting Questionnaire (SRQ) were evaluated in perinatal women in rural Ethiopia. Gold-standard measure of CMD was psychiatric assessment using the Comprehensive Psychopathological Rating Scale (CPRS). Community-based, convenience sampling was used. An initial validation study (n=101) evaluated both EPDS and SRQ. Subsequent validation was of SRQ alone (n=119).

RESULTS

EPDS exhibited poor validity; area under the receiver operating characteristic (AUROC) curve of 0.62 (95%CI 0.49 to 0.76). SRQ-20 showed better validity as a dimensional scale, with AUROC of 0.82 (95%CI 0.68 to 0.96) and 0.70 (95%CI 0.57 to 0.83) in the two studies. The utility of SRQ in detecting 'cases' of CMD was not established, with differing estimates of optimal cut-off score: three and above in Study 1 (sensitivity 85.7%, specificity 75.6%); seven and above in Study 2 (sensitivity 68.4%, specificity 62%). High convergent validity of SRQ as a dimensional measure was demonstrated in a community survey of 1065 pregnant women.

LIMITATIONS

Estimation of optimal cut-off scores and validity coefficients for detecting CMD was limited by sample size.

CONCLUSIONS

EPDS demonstrated limited clinical utility as a screen for perinatal CMD in this rural, low-income setting. The SRQ-20 was superior to EPDS across all domains for evaluating cultural equivalence and showed validity as a dimensional measure of perinatal CMD.

Authors+Show Affiliations

King's College London (Institute of Psychiatry), UK. charlotte.hanlon@iop.kcl.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

18055019

Citation

Hanlon, Charlotte, et al. "Detecting Perinatal Common Mental Disorders in Ethiopia: Validation of the Self-reporting Questionnaire and Edinburgh Postnatal Depression Scale." Journal of Affective Disorders, vol. 108, no. 3, 2008, pp. 251-62.
Hanlon C, Medhin G, Alem A, et al. Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale. J Affect Disord. 2008;108(3):251-62.
Hanlon, C., Medhin, G., Alem, A., Araya, M., Abdulahi, A., Hughes, M., Tesfaye, M., Wondimagegn, D., Patel, V., & Prince, M. (2008). Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale. Journal of Affective Disorders, 108(3), 251-62.
Hanlon C, et al. Detecting Perinatal Common Mental Disorders in Ethiopia: Validation of the Self-reporting Questionnaire and Edinburgh Postnatal Depression Scale. J Affect Disord. 2008;108(3):251-62. PubMed PMID: 18055019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale. AU - Hanlon,Charlotte, AU - Medhin,Girmay, AU - Alem,Atalay, AU - Araya,Mesfin, AU - Abdulahi,Abdulreshid, AU - Hughes,Marcus, AU - Tesfaye,Markos, AU - Wondimagegn,Dawit, AU - Patel,Vikram, AU - Prince,Martin, Y1 - 2007/12/04/ PY - 2007/08/22/received PY - 2007/10/31/revised PY - 2007/10/31/accepted PY - 2007/12/7/pubmed PY - 2008/10/22/medline PY - 2007/12/7/entrez SP - 251 EP - 62 JF - Journal of affective disorders JO - J Affect Disord VL - 108 IS - 3 N2 - BACKGROUND: The cultural validity of instruments to detect perinatal common mental disorders (CMD) in rural, community settings has been little-investigated in developing countries. METHODS: Semantic, content, technical, criterion and construct validity of the Edinburgh Postnatal Depression Scale (EPDS) and Self-Reporting Questionnaire (SRQ) were evaluated in perinatal women in rural Ethiopia. Gold-standard measure of CMD was psychiatric assessment using the Comprehensive Psychopathological Rating Scale (CPRS). Community-based, convenience sampling was used. An initial validation study (n=101) evaluated both EPDS and SRQ. Subsequent validation was of SRQ alone (n=119). RESULTS: EPDS exhibited poor validity; area under the receiver operating characteristic (AUROC) curve of 0.62 (95%CI 0.49 to 0.76). SRQ-20 showed better validity as a dimensional scale, with AUROC of 0.82 (95%CI 0.68 to 0.96) and 0.70 (95%CI 0.57 to 0.83) in the two studies. The utility of SRQ in detecting 'cases' of CMD was not established, with differing estimates of optimal cut-off score: three and above in Study 1 (sensitivity 85.7%, specificity 75.6%); seven and above in Study 2 (sensitivity 68.4%, specificity 62%). High convergent validity of SRQ as a dimensional measure was demonstrated in a community survey of 1065 pregnant women. LIMITATIONS: Estimation of optimal cut-off scores and validity coefficients for detecting CMD was limited by sample size. CONCLUSIONS: EPDS demonstrated limited clinical utility as a screen for perinatal CMD in this rural, low-income setting. The SRQ-20 was superior to EPDS across all domains for evaluating cultural equivalence and showed validity as a dimensional measure of perinatal CMD. SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/18055019/Detecting_perinatal_common_mental_disorders_in_Ethiopia:_validation_of_the_self_reporting_questionnaire_and_Edinburgh_Postnatal_Depression_Scale_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(07)00384-9 DB - PRIME DP - Unbound Medicine ER -