What is the best tool for screening antenatal depression?

Couto, Tiago Castro e; Brancaglion, Mayra Yara Martins; Cardoso, Mauro Nogueira; Protzner, Andressa Bergo; Garcia, Frederico Duarte; Nicolato, Rodrigo; Aguiar, Regina Amélia Lopes Pessoa de; Leite, Henrique Vítor; Corrêa, Humberto

doi:10.1016/j.jad.2015.02.003

Cited by 34 publications

(21 citation statements)

References 56 publications

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“…Overall the quality was satisfactory with six articles [1, 23, 25, 34–36] rated as excellent, three [37–39] good and two [3, 4] adequate. All the articles clearly described the selection criteria for the sample and reported the index test as independent of the gold standard.…”

Section: Resultsmentioning

confidence: 99%

“…The sensitivity and specificity of EPDS differed across studies which may be attributed to variations in study methodologies [43] and characteristics of populations under study [1]. The sensitivity of the EPDS across the 8 studies ranged from Se = .688 to Se = 1, with a specificity from Sp = .733 to Sp = .915.…”

Section: Resultsmentioning

confidence: 99%

“…Studies have found that instruments may have different levels of sensitivity and specificity when applied to women at different stages of pregnancy. In this review, the EPDS had both highest sensitivity (Se = 1.0) [4] and lowest sensitivity (Se = .69) [34] among third trimester pregnant women and BDI had different sensitivity values among second trimester pregnant women in Brazil [1, 39]. It was however not possible in this review it establish whether screening instruments may have different levels of sensitivity and specificity when applied to women at different stages of pregnancy due to inconsistencies in completeness of reporting in original studies.…”

Section: Discussionmentioning

confidence: 99%

“…Depression is a major health problem affecting pregnant women in low resource settings [1, 2] with high prevalence rates of antenatal depression (10.7 to 47%) [1–4]. Antenatal depression can lead to poor uptake of antenatal care, adverse birth outcomes [3] and is a risk factor for postnatal depression [5].…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of screening instruments for depression for use in antenatal services in low resource settings

Chorwe‐Sungani

Chipps

2017

BMC Psychiatry

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BackgroundIn low resource settings, short, valid and reliable instruments with good high sensitivity and specificity are essential for the screening of depression in antenatal care. A review of published evidence on screening instruments for depression for use in antenatal services in low resource settings was conducted. The aim of this review was to appraise the best available evidence on screening instruments suitable for detecting depression in antenatal care in low resource settings.MethodsSearching, selection, quality assessment, and data abstraction was done by two reviewers. ScienceDirect, CINAHL, MEDLINE, PubMed, SABINET and PsychARTICLES databases were searched using relevant search terms. Retrieved studies were evaluated for relevancy (whether psychometric data were reported) and quality. Data were synthesised and sensitivity and specificity of instruments were pooled using forest plots.ResultsEleven articles were included in the review. The methodological quality ranged from adequate to excellent. The review found 7 tools with varying levels of accuracy, sensitivity and specificity, including the Edinburgh Postnatal Depression Scale, Beck Depression Index, Centre for Epidemiologic Studies Depression Scale 20, Hamilton Rating Scale for Depression, Hopkins Symptoms Checklist-25, Kessler Psychological Distress Scale and Self-Reporting Questionnaire. The Edinburgh Postnatal Depression Scale was most common and had the highest level of accuracy (AUC = .965) and sensitivity.ConclusionThis review suggests that the Edinburgh Postnatal Depression Scale can be a suitable instrument of preference for screening antenatal depression in low resource settings because of the reported level of accuracy, sensitivity and specificity.Prospero registration CRD42015020316.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systematic review of screening instruments for depression for use in antenatal services in low resource settings

Chorwe‐Sungani

Chipps

2017

BMC Psychiatry

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“…The variations could be attributed to different cut-off scores used across studies. While it is evident that various screening tools for antenatal depression produce broader rates overall,62 it has been argued the tool’s sensitivity improves when used with lower cut-off scores 63. Although EPDS is one of the most widely used screening tools for assessing symptoms of depression, most of the local language versions of the EPDS from non–English-speaking low-income and middle-income countries had lower precision for identifying true cases of depression among women compared with the original English version 64…”

Section: Discussionmentioning

confidence: 99%

Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis

Mahendran

Puthussery

Amalan

2019

J Epidemiol Community Health

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ObjectiveTo estimate the prevalence of antenatal depression in South Asia and to examine variations by country and study characteristics to inform policy, practice and future research.MethodsWe conducted a comprehensive search of 13 databases including international databases and databases covering scientific literature from South Asian countries in addition to Google Scholar and grey sources from 1 January 2007 to 31 May 2018. Studies reporting prevalence estimates of antenatal depression using a validated diagnostic/screening tool were identified, screened, selected and appraised. Primary outcome was proportion (%) of pregnant women identified as having antenatal depression.ResultsThirty-three studies involving 13 087 pregnant women were included in the meta-analysis. Twelve studies were rated as high quality and 21 studies were of moderate quality. Overall pooled prevalence of antenatal depression was 24.3 % (95% Confidence Interval (CI) 19.03 to 30.47). Studies showed a high degree of heterogeneity (I2=97.66%) and evidence of publication bias (p=0.668). Prevalence rates for India (17.74%, 95% CI 11.19 to 26.96) and Sri Lanka (12.95%, 95% CI 8.29 to 19.68) were lower compared with the overall prevalence, whereas prevalence rates for Pakistan (32.2%, 95% CI 23.11 to 42.87) and Nepal (50%, 95% CI 35.64 to 64.36) were higher.ConclusionsWhile robust prevalence studies are sparse in most South Asian countries, available data suggest one in four pregnant women is likely to experience antenatal depression in the region. Findings highlight the need for recognition of the issue in health policy and practice and for resource allocation for capacity building at regional and national levels for prevention, diagnosis and treatment.

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Selective cutoff reporting in studies of the accuracy of the Patient Health Questionnaire‐9 and Edinburgh Postnatal Depression Scale: Comparison of results based on published cutoffs versus all cutoffs using individual participant data meta‐analysis

Neupane

Levis

Bhandari

et al. 2021

Int J Methods Psych Res

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What is the best tool for screening antenatal depression?

Cited by 34 publications

References 56 publications

A systematic review of screening instruments for depression for use in antenatal services in low resource settings

A systematic review of screening instruments for depression for use in antenatal services in low resource settings

Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis

Selective cutoff reporting in studies of the accuracy of the Patient Health Questionnaire‐9 and Edinburgh Postnatal Depression Scale: Comparison of results based on published cutoffs versus all cutoffs using individual participant data meta‐analysis

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