Detecting perinatal common mental disorders in Ethiopia: Validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale
Detecting perinatal common mental disorders in Ethiopia: Validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale
复制标题
DOI：
10.1016/j.jad.2007.10.023
复制
发表时间：
2008-06-01
影响因子：
6.6
通讯作者：
Prince, Martin
中科院分区：
文献类型：
--
作者：
Hanlon, Charlotte;Medhin, Girmay;Prince, Martin
背景资料：文化效度的文书，以检测围产期常见的精神障碍（CMD）在农村，社区设置已经很少调查在发展中国家。方法：语义，内容，技术，标准和结构效度的爱丁堡产后抑郁量表（EPDS）和自我报告问卷（SRQ）进行了评估，在埃塞俄比亚农村围产期妇女。CMD的金标准测量是使用综合精神病理评定量表（CPRS）进行精神评估。采用基于社区的便利抽样。初始验证研究（n=101）评价了EPDS和SRQ。结果：EPDS的有效性较差，受试者工作特征（AUROC）曲线下面积为0.62（95%CI 0.49 ~ 0.76）。SRQ-20作为维度量表显示了更好的效度，两项研究的AUROC分别为0.82（95%CI 0.68至0.96）和0.70（95%CI 0.57至0.83）。SRQ在检测CMD“病例”中的效用尚未确定，最佳截止评分的估计值不同：研究1中3分及以上（敏感性85.7%，特异性75.6%）;研究2中7分及以上（敏感性68.4%，特异性62%）。SRQ作为一个维度的措施表明，在社区调查的1065 pregnant women.Limitations：估计最佳截止分数和有效性系数检测CMD是有限的样本size.Conclusions：EPDS显示有限的临床实用性作为围产期CMD在这个农村，低收入的设置屏幕。SRQ-20在评价文化等效性的所有领域均上级于EPDS，并显示出作为围产期CMD维度测量的有效性。(c)2007 Elsevier B.V保留所有权利。
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. (c) 2007 Elsevier B.V All rights reserved.