Cited by 128Maternal Mental Health During Pregnancy and PostpartumAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMaternal and Neonatal Healthcare

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Validity of depression rating scales during pregnancy and the postpartum period: Impact of trimester and parity

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Ji, Shuang, Long, Qi, Jeffrey Newport, D., Na, Hyeji, Knight, Bettina, Zach, Elizabeth B., Morris, Natalie J., Kutner, Michael, Stowe, Zachary N.·2011·Journal of Psychiatric Research

DOI 10.1016/j.jpsychires.2010.05.017PMC PMC2945623

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Abstract

The objective of the current study was to delineate the optimal cutpoints for depression rating scales during pregnancy and the postpartum period and to assess the perinatal factors influencing these scores. Women participating in prospective investigations of maternal mental illness were enrolled prior to 28 weeks gestation and followed through 6 months postpartum. At each visit, subjects completed self-rated depression scales--Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) and clinician-rated scales--Hamilton Rating Scale for Depression (HRSD(17) and HRSD(21)). These scores were compared to the SCID Mood Module for the presence of fulfilling diagnostic criteria for a major depressive episode (MDE) during 6 perinatal windows: preconception; first trimester; 2nd trimester; 3rd trimester; early postpartum; and later postpartum. Optimal cutpoints were determined by maximizing the sum of each scale's sensitivity and specificity. Stratified ROC analyses determined the impact of previous pregnancy and comparison of initial to follow-up visits. A total of 534 women encompassing 640 pregnancies and 4025 follow-up visits were included. ROC analysis demonstrated that all 4 scales were highly predictive of MDE. The AUCs ranged from 0.857 to 0.971 and were all highly significant (p < .0001). Optimal cutpoints were higher at initial visits and for multigravidas and demonstrated more variability for the self-rated scales. These data indicate that both clinician-rated and self-rated scales can be effective tools in identifying perinatal episodes of major depression. However, the results also suggest that prior childbirth experiences and the use of scales longitudinally across the perinatal period influence optimal cutpoints.

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Authors: Ji, S., Long, Q., Jeffrey Newport, D., Na, H., Knight, B., Zach, E. B., Morris, N. J., Kutner, M., & Stowe, Z. N.
Affiliations: Emory University (US)
Corresponding author: Long, Qi
ORCID: Ji, Shuang
Long, Qi
Morris, Natalie J.
Kutner, Michael
Stowe, Zachary N.
Venue: Journal of Psychiatric Research
Publisher: Elsevier BV
Published: 2011-02
Volume: 45
Issue: 2
Pages: 213-219
ISSN: 0022-3956 (ISSN-L)
DOI: 10.1016/j.jpsychires.2010.05.017
PMC: PMC2945623
OpenAlex: W2108917431
Cited by: 128
References: 43
Citations by year: 2026: 4 · 2025: 1 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 12 · 2020: 10 · 2019: 11 · 2018: 8 · 2017: 15 · 2016: 12 · 2015: 12 · 2014: 7 · 2013: 12 · 2012: 5
FWCI: 6.28
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Journal of Psychiatric Research (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: School of Medicine, Emory University
National Institute of Mental Health (P50MH068036, P50MH077928)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: perinatal depression, major depressive episode, depression rating scales, Edinburgh Postnatal Depression Scale, Beck Depression Inventory, Hamilton Depression Rating Scale, cut-off values, sensitivity and specificity, pregnancy trimesters, parity, multigravida
MeSH terms: Adult, Depression, Female, Follow-Up Studies, Humans, Pregnancy, Pregnancy Trimesters, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Reproducibility of Results, Postpartum Period

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Validity of depression rating scales during pregnancy and the postpartum period: Impact of trimester and parity

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