Accuracy of Postpartum Screening Tools Evaluated

Tools used in urban, low-income mothers may need cutoff scores updated for accurate detection
By Eric Metcalf
HealthDay Reporter

MONDAY, Feb. 15 (HealthDay News) -- Depression is common in postpartum, low-income, urban mothers attending well-child care (WCC) visits, which may be identified by pediatricians with three screening tools, but cutoff scores may need to be changed to more accurately identify depression depending on the population and the screening tool utilized, according to research published online Feb. 15 in Pediatrics.

Linda H. Chaudron, M.D., of the University of Rochester in New York, and colleagues analyzed data from 198 mothers attending WCC visits with infants aged 14 months and younger. Most participants were African-American and had a low income. Participants underwent a psychiatric diagnostic interview and completed the Edinburgh Postnatal Depression Scale (EPDS), the Beck Depression Inventory II (BDI-II), and the Postpartum Depression Screening Scale (PDSS).

Based on the interviews, the researchers found that 56 percent of mothers met the criteria for major or minor depressive disorder. All the scales were equally accurate in identifying depression in this population. However, the researchers found that the optimal cutoff scores for the BDI-II and the EPDS were lower than the established cutoffs, which could cause some women with depression in this population to go unidentified.

"Depression is highly prevalent among low-income, black, postpartum mothers and can be identified accurately through screening with the EPDS, PDSS, or BDI-II. Depending on the population and the screening tool, practitioners may need to alter the cutoff score to identify more effectively individuals who could benefit from referral and treatment," the authors conclude.

A co-author reported financial relationships with Eli Lilly and Novartis.

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