Accuracy of Depression Screening Tools for Identifying Postpartum Depression Among Urban Mothers
Accuracy of Depression Screening Tools for Identifying Postpartum Depression Among Urban Mothers
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DOI：
10.1542/peds.2008-3261
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发表时间：
2010-03-01
期刊：
影响因子：
8
通讯作者：
Wisner, Katherine L.
中科院分区：
文献类型：
--
作者：
Chaudron, Linda H.;Szilagyi, Peter G.;Wisner, Katherine L.
目的：目的是描述爱丁堡产后抑郁量表 (EPDS)、贝克抑郁量表 II (BDI-II) 和产后抑郁筛查量表 (PDSS) 在识别产后参加儿童保健 (WCC) 的低收入城市母亲的重度抑郁症 (MDD) 或轻度抑郁症 (MnDD) 方面的准确性。 方法：参加儿童保健 (WCC) 的母亲 (N = 198) WCC 拜访了 0 至 14 个月大的婴儿，完成了一次精神病诊断访谈（标准方法）和 3 种筛查工具。与 MDD 或 MDD/MnDD 的诊断进行比较，计算每种筛查工具的敏感性和特异性。计算接受者操作特征曲线，并比较每个工具的曲线下面积，以评估整个样本（代表产后年份）和子样本（代表产后早期、中期和晚期时间范围）的准确性。计算出最佳截止分数。 结果：在产后 2 周到 14 个月之间的某个时间点，56% 的母亲符合 MDD (37%) 或 MnDD (19%) 的标准。当用作连续测量时，所有量表都表现得同样好（曲线下面积 >= 0.8）。使用传统的截止分数，这些措施没有达到预期的敏感性和特异性水平。 BDI-II（MDD >= 14，MDD/MnDD >= 11）和 EPDS（MDD >= 9，MDD/MnDD >= 7）的最佳截止分数低于当前建议的分数。对于 PDSS，最佳截止分数与当前 MDD 指南 (>= 80) 一致，但高于 MDD/MnDD 的建议值 (>= 77)。结论：参加 WCC 就诊的低收入城市母亲中，很大一部分在产后经历过 MDD 或 MnDD。 EPDS、BDI-II 和 PDSS 在识别抑郁症方面具有很高的准确性，但可能需要更改截止分数，以便更准确地识别城市低收入母亲的抑郁症。儿科2010; 125：e609-e617
OBJECTIVE: The goal was to describe the accuracy of the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory II (BDI-II), and Postpartum Depression Screening Scale (PDSS) in identifying major depressive disorder (MDD) or minor depressive disorder (MnDD) among low-income, urban mothers attending well-child care (WCC) visits during the postpartum year.METHODS: Mothers (N = 198) attending WCC visits with their infants 0 to 14 months of age completed a psychiatric diagnostic interview (standard method) and 3 screening tools. The sensitivities and specificities of each screening tool were calculated in comparison with diagnoses of MDD or MDD/MnDD. Receiver operating characteristic curves were calculated and the areas under the curves for each tool were compared to assess accuracy for the entire sample (representing the postpartum year) and subsamples (representing early, middle, and late postpartum time frames). Optimal cutoff scores were calculated.RESULTS: At some point between 2 weeks and 14 months after delivery, 56% of mothers met criteria for either MDD (37%) or MnDD (19%). When used as continuous measures, all scales performed equally well (areas under the curves of >= 0.8). With traditional cutoff scores, the measures did not perform at the expected levels of sensitivity and specificity. Optimal cutoff scores for the BDI-II (>= 14 for MDD and >= 11 for MDD/MnDD) and EPDS (>= 9 for MDD and >= 7 for MDD/MnDD) were lower than currently recommended. For the PDSS, the optimal cutoff score was consistent with current guidelines for MDD (>= 80) but higher than recommended for MDD/MnDD (>= 77).CONCLUSIONS: Large proportions of low-income, urban mothers attending WCC visits experience MDD or MnDD during the postpartum year. The EPDS, BDI-II, and PDSS have high accuracy in identifying depression, but cutoff scores may need to be altered to identify depression more accurately among urban, low-income mothers. Pediatrics 2010; 125: e609-e617