Chinese version of the Postpartum Depression Screening Scale: translation and validation

Postpartum depression is an important public health problem in China. Although 10%-20% of Chinese women having recently given birth are affected by postpartum depression, only 10% receive treatment due to the lack of proper screening.

The aims of this study were to translate the Postpartum Depression Screening Scale into Chinese (C-PDSS) and establish the psychometric properties of the C-PDSS.

The study was undertaken in three phases, composed of forward and backward translation of the Postpartum Depression Screening Scale into Chinese, examination of content validity, and field testing to establish the reliability, validity, and optimal cutoff score of the C-PDSS along with its sensitivity, specificity, and predictive values. A total sample of 387 mothers within 12 weeks postpartum participated in the study. Each mother was asked to complete the C-PDSS and the Chinese version of the Edinburgh Postnatal Depression Scale and then was interviewed by an experienced researcher using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision.

The Cronbach's alpha coefficient was .96 for the total C-PDSS, and the overall intraclass correlation was .79. Factor analysis of the scale revealed that it was composed of 7 factors with eigenvalues >1, accounting for 74.25% of the total variance. There was a significantly positive correlation between the C-PDSS and the Chinese version of the Edinburgh Postnatal Depression Scale (r = .66, p < .001). Discriminant validity suggested a statistically significant difference in the C-PDSS scores among the nondepressed, minor-depressed, and major-depressed participants. A cutoff score of 76.5 (sensitivity = 97.3% and specificity = 87.0%) was recommended for major and minor postpartum depression, and a cutoff score of 98 (sensitivity = 87.5% and specificity = 96.9%) was recommended for major postpartum depression. The area under the curve was 0.98 (95% confidence interval = 0.96-1.00) for major and minor postpartum depression and 0.99 (95% confidence interval = 0.98-1.01) for major postpartum depression.

The C-PDSS has satisfactory psychometric properties in screening postpartum depression among Chinese mothers. Future research would provide data for further validation using confirmatory factor analysis and generalization of the C-PDSS to a different sample in China.