Cited by 278Maternal Mental Health During Pregnancy and PostpartumHealth Education and ValidationMental Health Treatment and Access

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Detecting perinatal common mental disorders in Ethiopia: Validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale

Hanlon, Charlotte, Medhin, Girmay, Alem, Atalay, Araya, Mesfin, Abdulahi, Abdulreshid, Hughes, Marcus, Tesfaye, Markos, Wondimagegn, Dawit, Patel, Vikram, Prince, Martin·2008·Journal of Affective Disorders

DOI 10.1016/j.jad.2007.10.023

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Abstract

Background The cultural validity of instruments to detect perinatal common mental disorders (CMD) in rural, community settings has been little-investigated in developing countries.Methods Semantic, content, technical, criterion and construct validity of the Edinburgh Postnatal Depression Scale (EPDS) and Self-Reporting Questionnaire (SRQ) were evaluated in perinatal women in rural Ethiopia. Gold-standard measure of CMD was psychiatric assessment using the Comprehensive Psychopathological Rating Scale (CPRS). Community-based, convenience sampling was used. An initial validation study (n=101) evaluated both EPDS and SRQ. Subsequent validation was of SRQ alone (n=119).Results EPDS exhibited poor validity; area under the receiver operating characteristic (AUROC) curve of 0.62 (95%CI 0.49 to 0.76). SRQ-20 showed better validity as a dimensional scale, with AUROC of 0.82 (95%CI 0.68 to 0.96) and 0.70 (95%CI 0.57 to 0.83) in the two studies. The utility of SRQ in detecting 'cases' of CMD was not established, with differing estimates of optimal cut-off score: three and above in Study 1 (sensitivity 85.7%, specificity 75.6%); seven and above in Study 2 (sensitivity 68.4%, specificity 62%). High convergent validity of SRQ as a dimensional measure was demonstrated in a community survey of 1065 pregnant women.Limitations Estimation of optimal cut-off scores and validity coefficients for detecting CMD was limited by sample size.Conclusions EPDS demonstrated limited clinical utility as a screen for perinatal CMD in this rural, low-income setting. The SRQ-20 was superior to EPDS across all domains for evaluating cultural equivalence and showed validity as a dimensional measure of perinatal CMD.

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Authors: Hanlon, C., Medhin, G., Alem, A., Araya, M., Abdulahi, A., Hughes, M., Tesfaye, M., Wondimagegn, D., Patel, V., & Prince, M.
Affiliations: King's College London (GB)
Addis Ababa University (ET)
London School of Hygiene & Tropical Medicine (GB)
Corresponding author: Hanlon, Charlotte
ORCID: Hanlon, Charlotte
Medhin, Girmay
Alem, Atalay
Hughes, Marcus
Tesfaye, Markos
Wondimagegn, Dawit
Patel, Vikram
Prince, Martin
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2008-06
Volume: 108
Issue: 3
Pages: 251-262
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2007.10.023
OpenAlex: W1974901321
Cited by: 278
References: 46
Citations by year: 2026: 10 · 2025: 12 · 2024: 18 · 2023: 21 · 2022: 20 · 2021: 32 · 2020: 25 · 2019: 17 · 2018: 13 · 2017: 11 · 2016: 14 · 2015: 13 · 2014: 14 · 2013: 17 · 2012: 8
FWCI: 8.27
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Funders: Wellcome Trust (GR071643MA)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Nursing › Research and Theory › Health Education and Validation
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: Edinburgh Postnatal Depression Scale, Self-Reporting Questionnaire, SRQ-20, screening tool validation, cultural validity, rural Ethiopia, pregnant women, cut-off values, convergent validity, dimensional metrology
MeSH terms: Adult, Mental Disorders, Catchment Area, Health, Ethiopia, Female, Humans, Mass Screening, Perinatology, Puerperal Disorders, Surveys and Questionnaires, Reproducibility of Results, Prevalence, Depression, Postpartum

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Detecting perinatal common mental disorders in Ethiopia: Validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale

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