Validation of the Edinburgh Postnatal Depression Scale among women in a high HIV prevalence area in urban Zimbabwe
Validation of the Edinburgh Postnatal Depression Scale among women in a high HIV prevalence area in urban Zimbabwe
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DOI：
10.1007/s00737-009-0073-6
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发表时间：
2010-06-01
影响因子：
4.5
通讯作者：
Shetty, Avinash K.
中科院分区：
文献类型：
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作者：
Chibanda, Dixon;Mangezi, Walter;Shetty, Avinash K.
尽管撒哈拉以南非洲妇女的常见精神障碍（CMD）负担很大，但关于产后抑郁症（PND）的数据非常有限，尤其是在艾滋病毒较高的情况下。爱丁堡产后抑郁量表（EPDS）是PND广泛使用的筛查测试，在许多国家已经验证，但在津巴布韦没有得到验证。我们评估了产后女性EPDS量表的有效性，与精神障碍（DSM-IV）严重抑郁症标准（DSM-IV）标准相比。六名受过训练的社区辅导员将EPD的Shona版本管理给了210个产后感染和未感染的妇女，该样本在Chitungwiza的两家初级保健诊所就诊。随后，所有妇女使用DSM IV的严重抑郁症标准对2位精神科医生进行了心理状态检查，这些精神科医生对受试者的EPDS分数视而不见。使用接收器操作特征（ROC）曲线分析分析数据。在招收的210名产后母亲中，有64（33％）符合DSM IV抑郁症标准。使用Shona版本的EPDS抑郁症的截止分数为11/12，灵敏度为88％，特异性为87％，正预测值为74％，负预测值为94％，曲线下的面积为0.82。 Cronbach的整个尺度的α系数为0.87。结论：EPDS的Shona版本是在津巴布韦的HIV感染和未感染的妇女中筛选PND的可靠且有效的工具。 PND的筛查应在艾滋病毒较高的地区的常规产前和产后护理中纳入。
Despite the significant burden of common mental disorders (CMD) among women in sub Saharan Africa, data on postnatal depression (PND) is very limited, especially in settings with a high HIV prevalence. The Edinburgh Postnatal Depression Scale (EPDS), a widely used screening test for PND has been validated in many countries, but not in Zimbabwe. We assessed the validity of the EPDS scale among postpartum women compared with Diagnostic Manual of Mental Disorders (DSM-IV) criteria for major depression. Six trained community counselors administered the Shona version of the EPDS to a random sample of 210 postpartum HIV-infected and uninfected women attending two primary care clinics in Chitungwiza. All women were subsequently subjected to mental status examination using DSM IV criteria for major depression by 2 psychiatrists, who were blinded to the subject's EPDS scores. Data were analyzed using receiver operating characteristic (ROC) curve analysis. Of the 210 postpartum mothers enrolled, 64 (33%) met DSM IV criteria for depression. Using a cut-off score of 11/12 on the Shona version of the EPDS for depression, the sensitivity was 88%, and specificity was 87%, with a positive predictive value of 74%, a negative predictive value of 94%, and an area under the curve of 0.82. Cronbach's alpha coefficient for the whole scale was 0.87. Conclusion: The Shona version of the EPDS is a reliable and valid tool to screen for PND among HIV-infected and un-infected women in Zimbabwe. Screening for PND should be integrated into routine antenatal and postnatal care in areas with high HIV prevalence.