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Related Experiment Videos

Postdelivery screening for postpartum depression.

Dominic T S Lee1, Alexander S K Yip, Sandra S M Chan

  • 1Department of Psychiatry, Chinese University of Hong Kong, Sha Tin, Hong Kong. tak_lee@hms.harvard.edu

Psychosomatic Medicine
|May 24, 2003
PubMed
Summary

Screening for postpartum depression (PPD) using common scales within two days of delivery is unreliable. Healthcare providers should avoid early PPD screening due to unsatisfactory psychometric properties of the tests.

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Area of Science:

  • Psychiatry
  • Obstetrics
  • Perinatal Mental Health

Background:

  • Postpartum depression (PPD) affects 10-20% of women post-childbirth.
  • Systematic PPD screening improves identification and treatment initiation.
  • Most PPD screening research focuses on later postpartum periods, with limited data on immediate postpartum screening.

Purpose of the Study:

  • To evaluate the psychometric performance of commonly used depression screening scales (EPDS, BDI, GHQ) within 48 hours of delivery.
  • To determine the feasibility and accuracy of early postpartum PPD screening.

Main Methods:

  • A prospective cohort of 145 women completed the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and General Health Questionnaire (GHQ) within 2 days of delivery.
  • A psychiatrist conducted a Structured Clinical Interview for DSM-III-R (SCID) at 6 weeks postpartum to establish a gold standard diagnosis.

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  • The sensitivity and positive predictive values of the screening scales were assessed against the SCID diagnosis.

    • Main Results:

    • Lowering scale cutoffs to achieve 80% sensitivity resulted in low positive predictive values (13-21%).
    • Raising cutoffs for a 50% positive predictive value yielded low sensitivity rates (6-36%).
    • The psychometric properties of EPDS, BDI, and GHQ were unsatisfactory for immediate postpartum PPD screening.

    Conclusions:

    • Commonly used depression rating scales demonstrate poor psychometric performance when administered immediately after delivery.
    • Healthcare providers are advised against screening for postpartum depression in the first few days following childbirth.