Postpartum Depression Screening Scale: Its Availability for Use.

OBJECTIVE: A silent health crisis in the United States is the underdiagnosed and undertreated mental health of women related to childbirth. This discussion paper describes the Postpartum Depression Screening Scale (PDSS) with its scoring and interpretation along with its psychometric testing and translations. METHOD: In addition to the studies conducted by the instrument developers, databases were searched for studies where other researchers used the PDSS to assess postpartum depressive symptoms. Studies were included that measured the psychometrics of the scale and studies that reported the translation of the PDSS into other languages. RESULTS: Evidence is presented that the PDSS is a reliable and valid screening scale for use by psychiatric mental health nurses and other health care providers. The scale also has been translated into 14 languages, so it is available to screen non-English speaking mothers. CONCLUSION: Childbirth is one of the most powerful triggers of psychiatric illness in a woman's life. Postpartum depression is a treatable mental health condition, but first, women need to be screened so they can be identified and referrals made. Screening for this devastating mood disorder in new mothers is an essential role of psychiatric mental health nurses and other clinicians so that treatment can be started as early as possible to avoid harmful consequences.

Development of a Short Form Depression Screening Questionnaire for Korean Soldiers.

BACKGROUND: The frequencies of South Korean soldiers' depression and resulting suicide are increasing every year. Thus, this study aimed to develop and confirm the reliability and validity of a simple short form depression screening scale for soldiers. METHODS: This study was conducted as part of a 2013 research project named 'The Epidemiological Study on the Prevalence of Depression in Military Service and a Search for High Risk Group Management.' Clinical depression was diagnosed using the Korean version of the Mini International Neuropsychiatric Interview and suicide risk was assessed through the Korean version of the Composite International Diagnostic Interview. Furthermore, the Center for Epidemiological Studies for Depression Scale (CES-D), the Stress Response Inventory, and the Barret Impulsiveness Scale were employed. Of the 20 CES-D items, three of the most correlated items with clinical diagnosis were derived to form the short form scale. Analyses for internal consistency, concurrent validity, and factor analysis were implemented for its validation. We performed a receiver operating curve (ROC) analysis using a clinical diagnosis of depression as a gold standard to calculate the area under the curve (AUC) value, cut-off score, and corresponding sensitivity and specificity to that cut-off score. RESULTS: According to the results of the correlation analysis, 7, 18, and 4 were selected to be on our scale. The three-item scale was reliable with a Cronbach's alpha value of 0.720, and a factor was derived from the factor analysis. The ROC analysis showed a high discriminant validity, with an AUC value of 0.891. The sensitivity and specificity were 84.8% and 78.2%, and 71.7% and 91.6%, respectively, for each when the selected cut-off scores were 2 and 3, respectively. Depression screened through the scale when the cut-off score was 2 or 3 was significantly associated with suicidality, stress, and social support. CONCLUSION: The depression screening questionnaire for Korean soldiers developed through this study demonstrated high reliability and validity. Since it comprises only three items, it can be utilized easily and frequently. It is expected to be employed in a large-scale suicide prevention project targeting military soldiers in the future; it will be beneficial in selecting high-risk groups for depression.

Factor Analysis of the Prediction of the Postpartum Depression Screening Scale.

Postpartum depression (PPD), a severe form of clinical depression, is a serious social problem. Fortunately, most women with PPD are likely to recover if the symptoms are recognized and treated promptly. We designed two test data and six classifiers based on 586 questionnaires collected from a county in North Carolina from 2002 to 2005. We used the C4.5 decision tree (DT) algorithm to form decision trees to predict the degree of PPD. Our study established the roles of attributes of the Postpartum Depression Screening Scale (PDSS), and devised the rules for classifying PPD using factor analysis based on the participants' scores on the PDSS questionnaires. The six classifiers discard the use of PDSS Total and Short Total and make extensive use of demographic attributes contained in the PDSS questionnaires. Our research provided some insightful results. When using the short form to detect PPD, demographic information can be instructive. An analysis of the decision trees established the preferred sequence of attributes of the short form of PDSS. The most important attribute set was determined, which should make PPD prediction more efficient. Our research hopes to improve early recognition of PPD, especially when information or time is limited, and help mothers obtain timely professional medical diagnosis and follow-up treatments to minimize the harm to families and societies.

A longitudinal study of perinatal depression among Chinese high-risk pregnant women.

BACKGROUND: Information is needed on the prevalence of depression in Chinese women with medically defined complications across the perinatal period, as well as key risk factors to develop appropriate perinatal mental health services and ensure the services target those most in need. AIM: The goal of this study was to examine whether women's perinatal depression scores change across the perinatal period and evaluate risk factors associated with postnatal depression at 6-weeks after delivery. METHODS: A sample of 167 Chinese pregnant women with medically defined complications and an Edinburgh Postnatal Depression Scale≥9 and/or a Postpartum Depression Screening Scale≥60 were followed throughout early pregnancy (<28 weeks), late pregnancy (>28 weeks), 3-days and 6-weeks after delivery. FINDINGS: Repeated measures analysis of variance showed that there were significant differences on the Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale scores at each time point between high-risk depressed and low-risk depressed groups. Binary logistic regression indicated a significant association between postnatal depression at 6-weeks after delivery and depression in late pregnancy and 3-days after delivery, postnatal stress events, postnatal complications, and concerns about the fetus. CONCLUSIONS: Postnatal depression is a common condition with limited research among Chinese pregnant women with medically defined complications. Additional research is warranted to develop strategies to identify high-risk depressed pregnant women as well as effective treatment options during the perinatal period.

Combined use of the postpartum depression screening scale (PDSS) and Edinburgh postnatal depression scale (EPDS) to identify antenatal depression among Chinese pregnant women with obstetric complications.

The purpose of the present study was to evaluate antenatal depression screening employing two scales: the Postpartum Depression Screening Scale (PDSS) and Edinburgh Postnatal Depression Scale (EPDS) for the population of Chinese pregnant women with obstetric complications. A convenience sample of 842 Chinese pregnant women with complications participated in this study. The PDSS total score correlated strongly with the EPDS total score (r=0.652, p=0.000). Each tool performed extremely well for detecting major and major/minor depressions with PDSS resulting in a better psychometric performance than EPDS (p<0.01). If combined use, the recommended EPDS cut-off score was 8/9 for major depression, at which the sensitivity (71.6%) and specificity (87.6%) were the best, and the recommended PDSS cut-off score was 79/80 for major depression, along with its best sensitivity (86.4%) and specificity (100%). The study concluded that EPDS and PDSS appear to be reliable assessments for major and minor depression among the Chinese pregnant women with obstetric complications. Combined use of these tools should consider lower cutoff scores to reduce the misdiagnosis and improve the screening validity.

Sintomatologia depressiva no termo da gestação, em mulheres de baixo risco / Depressive symptomatology at full-term pregnancy in low risk women

RESUMO Objetivos Calcular a prevalência de sintomatologia depressiva pré-natal em grávidas de baixo risco, no termo da gestação, avaliar seus preditores e desfechos materno-fetais. Para tal, avaliar-se-á a aplicabilidade da Escala de Rastreio de Depressão Pós-Parto (PDSS 24) nessa fase da gravidez. Métodos A PDSS 24 e um questionário sociodemográfico, psicossocial e médico (antecedentes obstétricos e patológicos) foram autoaplicados a 403 grávidas (37-40 semanas de gestação), com idade média de 30,5 anos (DP = 4,67). Por meio do processo clínico, foram recolhidos dados de resultados materno-fetais. Resultados A PDSS 24 possui propriedades psicométricas adequadas para a deteção de sintomatologia depressiva pré-natal. A prevalência de sintomatologia depressiva pré-natal foi de 41,7%. Grávidas com níveis de escolaridade inferiores, não casadas, cuja gravidez não foi planejada e com antecedentes de acontecimentos de vida significativos apresentam risco duas vezes superior de sintomatologia depressiva no período pré-natal. Grávidas cujo apoio social percebido ao longo da gravidez não correspondeu ao desejado e com história prévia de depressão apresentam cerca de três vezes maior risco sintomatologia depressiva no período pré-natal. Para desfechos materno-fetais (pré-eclâmpsia, restrição de crescimento fetal, Apgar 1º/5º minuto, tipo de parto, percentil de peso, oligoâminos e necessidade de cuidados intensivos), as diferenças foram não significativas. Conclusão O rastreio da depressão pré-natal deve ser realizado na gravidez. Porém, no termo da gestação o uso da PDSS 24 como ferramenta de deteção de sintomatologia depressiva deve ser feito com cautela. A elevada prevalência de sintomas relacionados com o sono nessa fase da gestação pode conduzir ao sobre diagnóstico, usando a PDSS 24.

ABSTRACT Objectives The aims of the study were to estimate the prevalence of depressive symptomatology in full-term pregnancy (low risk), evaluate their predictors and maternal-fetal outcomes. To this end, the applicability of Postpartum Depression Screening Scale (PDSS 24) will be evaluated, at full-term pregnancy. Methods PDSS 24 and a sociodemographic, psychosocial, pathological and obstetrical background questionnaire were self-administered to 403 pregnant women (37-40 weeks gestation), with a mean age of 30.5 years (SD = 4.67). Data from maternal, fetal and neonatal outcomes were collected from the patient clinical process. Results PDSS 24 revealed adequate psychometric properties to screening depressive symptomatology in full-term pregnancy. The prevalence of depressive symptomatology was 41.7%. Pregnant women with lower study levels, who weren't married, whose pregnancy was unplanned and with a previous history of significant life events present twice the risk to present depressive symptomatology. Pregnant women who hadn't received the desired social support in pregnancy and with a history of depression present about a 3-fold increased risk to present depressive symptomatology. For maternal-fetal outcomes (pre-eclampsia, fetal growth restriction, Apgar score at 1st/5th minute, type of delivery, weight percentile, oligohydramnios and need for neonatal intensive care), the differences were not significant. Conclusion Screening for prenatal depression should be conducted during pregnancy. However, in full-term pregnancy women, the use of PDSS 24 as a screening tool for depressive symptomatology should be done with caution. The high prevalence of sleep-related symptoms, in full-term pregnancy, may lead to overdiagnosis, using PDSS 24.

Evaluation of the psychometric measures for the Postpartum Depression Screening Scale-Spanish Version for Mexican women.

This study assessed the reliability, validity, sensitivity, specificity, and predictive values of the Spanish Postpartum Depression Screening Scale (PDSS-Spanish Version) for Mexican women. The scale was administered at 6 weeks (T1; n = 149) and between 4 and 6 months postpartum (T2; n = 156). Women also completed the Beck Depression Inventory-Second Edition (BDI-II) and the mood module of the Standardized Clinical Interview for DSM-IV (SCID). At both time points, the internal consistency value of the PDSS-Spanish Version was α = .96. Concurrent validity was adequate, compared with the BDI-II (T1: r = .75; T2: r = .74, ps < .01) and the SCID (T1: r = .43; T2: r = .36, ps < .01). Based on receiver operator characteristic curves, cutoff scores on the PDSS-Spanish Version of 60 for depressive symptoms (BDI-II as gold standard) and 80 for major depression (SCID) showed high sensitivity (>88.9%) but low specificity (60.9% to 70.6%). More parsimonious values are obtained at a cutoff of 77 for subsyndromal depression and 95 for major depression. The choice for using different cutoff scores may depend on the purpose of using the instrument. Overall, the psychometric properties for the PDSS-Spanish Version in Mexican women are similar to the ones obtained in Hispanic women in the United States.

Validación del cuestionario Postpartum depression screening scale versión en español en mujeres de Arica, Chile / Validation of the Postpartum depression screening scale spanish version in women from Arica, Chile

La depresión postparto (DPP) puede ser difícil de detectar, principalmente porque las madres no informan los síntomas depresivos que pueden estar sintiendo a los profesionales de salud. El objetivo de este estudio fue poner a prueba la versión en español de la Escala de Depresión Postparto (PDSS) en una población de mujeres de Arica, Chile. El muestreo incluyó una muestra por conveniencia de 179 mujeres con dos o más semanas de postparto que asistieron a Consultorios de Atención Primaria. Se obtuvieron datos sobre características socio-demográficas y reproductivas y se aplicó el PDSS para pesquisar DPP. El 46,4 por ciento de las mujeres presentaron síntomas significativos de DPP. “Pensamientos suicidas” y “Pérdida del yo” fueron los síntomas más mencionados (34,1 por ciento y 26,3 por ciento, respectivamente). La gran mayoría de las participantes obtuvo un índice de inconsistencia de respuesta bajo; lo que indica que el cuestionario fue entendible. Se obtuvo un coeficiente de confiabilidad (Alfa de Cronbach) de .96. Seis de las siete dimensiones del PDSS-versión en español contribuyeron excelentemente a clasificar las participantes con depresión de las sin depresión. La validez de constructo se exploró a través del grado de interrelación entre escalas, encontrándose una alta correlación entre éstas. El análisis de factores reveló ocho componentes en la matriz con varianza explicada de 67,85 por ciento. Se concluye que el PDSS-versión en español obtuvo una adecuada confiabilidad al ser puesto a prueba en esta población. Se recomienda seguir poniendo a prueba este instrumento en mujeres de otras regiones de Chile.

Postpartum depression (PPD) can be difficult to detect; mainly because mothers do not report depressive symptoms they may be feeling to health care providers. The objective of this study was to test the Postpartum Depression Screening Scale (PDSS) Spanish version in a group of women in Arica, Chile. The convenience sample included 179 women with 2 or more weeks postpartum attending Primary Care Clinics. Data on reproductive and sociodemographic characteristics were obtained. The PDSS was utilized for assessment of PPD. Symptoms of postpartum depression was found among 46.4 percent of the women. “Suicidal thoughts” and “Loss of self” were the most commonly reported symptoms (34.1 percent and 26.3 percent respectively). The majority of the participants obtained a low Inconsistent Responding Index, indicating that the scale was understood. A reliability coefficient of .96 was obtained (Cronbach Alpha). Six of the seven dimensions of the PDSS-Spanish Version distinguished between groups by depression status. Construct validity was tested using degree of interrelatedness among the scales, identifying those correlated highly with each other. Factor analysis revealed eight components with explained variance of 67.85 percent. It is concluded that the PDSS-Spanish Version obtained an adequate reliability in this population. Recommendation is for further assessment of this tool among women in other regions of Chile.