Affective (depressive) morbidity in puerperal Nigerian women: validation of the Edinburgh Postnatal Depression Scale

To determine the rate of depression in a group of postpartum Nigerian women and to validate the Edinburgh Postnatal Depression Scale (EPDS) in this group.

Between April and August 2000, all postpartum women who remained in the maternity ward for up to 7 days, and those who attended the postnatal clinics of Nnamdi Azikiwe University Teaching Hospital were recruited. Translated local language versions of the EPDS and the Zung Self-Rating Depression Scale were used to screen the subjects. A structured interview schedule was adapted from the depression section of the Composite International Diagnostic Interview and affective module of the ICD-10 Symptom Check List to assess screened subjects.

The total rejection rate was 23%, with 225 women participating in the study. Twenty-four subjects (10.7%) had depression. At the optimal cut-off score of 9, the EPDS had a sensitivity of 0.75, and specificity of 0.97.

The EPDS clearly distinguished between depressed and non-depressed postpartum mothers (t = 7.63, P < 0.001, df = 222). Because of its brevity and acceptability, it is recommended that the EPDS be used in routine postnatal screening.