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Test performance of two-question screening for postpartum depressive symptoms
Hiroki Mishina1, Yasuaki Hayashino, Shunichi Fukuhara
1Department of Epidemiology and Healthcare Research, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe, Sakyo, Kyoto, Japan. mishina@st.pbh.med.kyoto-u.ac.jp
A brief, two-question screening tool effectively identifies mothers with postpartum depressive symptoms during well-child visits. This tool shows high sensitivity and negative predictive value, suggesting it can help rule out the need for further postpartum depression evaluation.
Area of Science:
- Obstetrics and Gynecology
- Psychiatry
- Primary Care Medicine
Background:
- Postpartum depression screening is crucial but challenging during routine well-child visits due to time constraints with the Edinburgh Postnatal Depression Scale (EPDS).
- A concise screening tool is needed to efficiently identify mothers experiencing postpartum depressive symptoms.
Purpose of the Study:
- To evaluate the performance of a brief, two-question screening tool for detecting postpartum depressive symptoms.
- To assess its accuracy compared to the established Edinburgh Postnatal Depression Scale (EPDS).
Main Methods:
- A study involving 103 mothers at a single hospital during 1-month well-child visits.
- Mothers completed both the EPDS and a two-question screening tool assessing depressive mood and anhedonia.
- Sensitivity, specificity, predictive values, and likelihood ratios were calculated using EPDS as the reference standard.
Main Results:
- The two-question tool demonstrated 88% sensitivity and 97% negative predictive value in detecting postpartum depressive symptoms.
- Specificity was 76%, with positive predictive value at 42%.
- Likelihood ratios varied by score, indicating diagnostic utility.
Conclusions:
- A two-question screening tool with a cut-off of 1 shows high sensitivity for identifying postpartum depressive symptoms at 1-month visits.
- A negative result from this brief tool may reliably indicate no further postpartum depression evaluation is needed in primary care settings.
