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Course of depression symptoms between 3 and 8 months after delivery using two screening tools (EPDS and HSCL-10) on a sample of Sudanese women in Khartoum state.
BMC Pregnancy Childbirth. 2018 Aug 08; 18(1):324.BP

Abstract

BACKGROUND

Effects of depression on parenting and on cognitive development of newborns are augmented when symptoms continue throughout the first postnatal year. Current classification systems recognize maternal depression as postnatal if symptoms commence within four to six weeks. Traditional cultural rituals in Sudan offer new mothers adequate family support in the first 6-8 weeks postpartum. The course of postnatal depression symptoms beyond that period is not explored in such settings. We therefore aim to investigate the change in screening status and in severity of depression and distress symptoms between three and eight months postpartum among a sample of Sudanese women using the Edinburgh Postnatal Depression Scale (EPDS) and a locally used tool: the 10-items Hopkins Symptoms Checklist (HSCL-10).

METHODS

Three hundred pregnant women in their 2nd or 3rd trimester were recruited from two clinics in Khartoum state. They were followed up and screened for depression symptoms eight months after delivery by EPDS at ≥12, and by HSCL-10 at ≥1.85. The same sample was previously screened for depression at three months after birth.

RESULTS

Prevalence of postnatal depression symptoms by EPDS was lower at eight months compared to three months after birth (3.6% at eight months (8/223) compared to 9.2% at three months (22/238), p <  0.001). Eight Mothers exhibited depression symptoms eight months after birth. Depressed mothers at three months had a 56% reduction in EPDS mean scores by eight months and 96.4% of participants either remained in the same EPDS category, or improved eight months after birth. Four participants with major depression symptoms at eight months were also depressed three months after birth and four participants had new onset depression symptoms. The HSCL-10 measured higher distress than EPDS across the two screening points (19.3% at three months, 9.1% at eight months postpartum, p <  0.001). Nonetheless, the two tests correlated positively at both points.

CONCLUSIONS

Repeated screenings by EPDS (depression surveillance) is recommended during the first postnatal year because a subset of mothers can have symptoms beyond the early postnatal period. Existing depression screening instruments can be assessed for their validity to detect PND.

Authors+Show Affiliations

Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway. dinasami5071@hotmail.com. Faculty of Health Sciences, Ahfad University for Women, Khartoum, Sudan. dinasami5071@hotmail.com.VID Specialized University, Oslo, Norway.Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway.National Advisory Board on Dual Diagnosis, Innlandet Hospital Trust, Hamar, Norway. Department of Public Health, Hedmark University College, Elverum, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30089466

Citation

Khalifa, Dina Sami, et al. "Course of Depression Symptoms Between 3 and 8 months After Delivery Using Two Screening Tools (EPDS and HSCL-10) On a Sample of Sudanese Women in Khartoum State." BMC Pregnancy and Childbirth, vol. 18, no. 1, 2018, p. 324.
Khalifa DS, Glavin K, Bjertness E, et al. Course of depression symptoms between 3 and 8 months after delivery using two screening tools (EPDS and HSCL-10) on a sample of Sudanese women in Khartoum state. BMC Pregnancy Childbirth. 2018;18(1):324.
Khalifa, D. S., Glavin, K., Bjertness, E., & Lien, L. (2018). Course of depression symptoms between 3 and 8 months after delivery using two screening tools (EPDS and HSCL-10) on a sample of Sudanese women in Khartoum state. BMC Pregnancy and Childbirth, 18(1), 324. https://doi.org/10.1186/s12884-018-1948-1
Khalifa DS, et al. Course of Depression Symptoms Between 3 and 8 months After Delivery Using Two Screening Tools (EPDS and HSCL-10) On a Sample of Sudanese Women in Khartoum State. BMC Pregnancy Childbirth. 2018 Aug 8;18(1):324. PubMed PMID: 30089466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Course of depression symptoms between 3 and 8 months after delivery using two screening tools (EPDS and HSCL-10) on a sample of Sudanese women in Khartoum state. AU - Khalifa,Dina Sami, AU - Glavin,Kari, AU - Bjertness,Espen, AU - Lien,Lars, Y1 - 2018/08/08/ PY - 2017/09/17/received PY - 2018/07/24/accepted PY - 2018/8/10/entrez PY - 2018/8/10/pubmed PY - 2019/3/20/medline KW - Course of depression KW - EPDS KW - HSCL-10 KW - Maternal distress KW - Postnatal depression KW - Screening SP - 324 EP - 324 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 18 IS - 1 N2 - BACKGROUND: Effects of depression on parenting and on cognitive development of newborns are augmented when symptoms continue throughout the first postnatal year. Current classification systems recognize maternal depression as postnatal if symptoms commence within four to six weeks. Traditional cultural rituals in Sudan offer new mothers adequate family support in the first 6-8 weeks postpartum. The course of postnatal depression symptoms beyond that period is not explored in such settings. We therefore aim to investigate the change in screening status and in severity of depression and distress symptoms between three and eight months postpartum among a sample of Sudanese women using the Edinburgh Postnatal Depression Scale (EPDS) and a locally used tool: the 10-items Hopkins Symptoms Checklist (HSCL-10). METHODS: Three hundred pregnant women in their 2nd or 3rd trimester were recruited from two clinics in Khartoum state. They were followed up and screened for depression symptoms eight months after delivery by EPDS at ≥12, and by HSCL-10 at ≥1.85. The same sample was previously screened for depression at three months after birth. RESULTS: Prevalence of postnatal depression symptoms by EPDS was lower at eight months compared to three months after birth (3.6% at eight months (8/223) compared to 9.2% at three months (22/238), p <  0.001). Eight Mothers exhibited depression symptoms eight months after birth. Depressed mothers at three months had a 56% reduction in EPDS mean scores by eight months and 96.4% of participants either remained in the same EPDS category, or improved eight months after birth. Four participants with major depression symptoms at eight months were also depressed three months after birth and four participants had new onset depression symptoms. The HSCL-10 measured higher distress than EPDS across the two screening points (19.3% at three months, 9.1% at eight months postpartum, p <  0.001). Nonetheless, the two tests correlated positively at both points. CONCLUSIONS: Repeated screenings by EPDS (depression surveillance) is recommended during the first postnatal year because a subset of mothers can have symptoms beyond the early postnatal period. Existing depression screening instruments can be assessed for their validity to detect PND. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/30089466/Course_of_depression_symptoms_between_3_and_8 months_after_delivery_using_two_screening_tools__EPDS_and_HSCL_10__on_a_sample_of_Sudanese_women_in_Khartoum_state_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1948-1 DB - PRIME DP - Unbound Medicine ER -