Screening for postnatal depression in the developing world: a comparison of the Who Self-Reporting Questionnaire [Srq-20] And The Edinburgh Postnatal Depression Screen [Epds]

This study was conducted to compare the suitability, usefulness, and validity of the Self Reporting Questionnaire [SRQ-20] and the Edinburgh Postnatal Depression Scale [EPDS] for screening postnatal depression in a mostly non-literate, rural, postnatal population of Pakistani women.Comparative Study.Ten union councils of Southern Kahuta, a rural sub-district of Rawalpindi, Pakistan during January to September 2002 [a total of nine months].Translation and cultural adaptation of all instruments was carried out using a rigorous seven-step procedure. A total of 541 women were administered the SRQ-20 and EPDS by trained health workers, and later interviewed with WHO Schedules for Clinical Assessment in Neuropsychiatry [SCAN]. Receiver Operating Curve [ROC] analysis was undertaken. ROC curves for the SRQ show values for the ROC area under the curve of 0.82 [95% CI: 0.78 to 0.86]. The corresponding values for EPDS are 0.84 [95% CI: 0.81 to 0.88]. The effects of varying cut-off points on the sensitivity, specificity, and positive predictive value are described.This study shows that when used by trained health workers after cultural adaptation, the SRQ-20 is equally effective as EPDS in screening for postnatal depression. The health workers preferred to use the SRQ20 with non-literate women because of its simpler format

In-patient psychiatric morbidity in a tertiary care mental health facility: a study Based on A psychiatric case register

Psychiatric morbidity constitutes one of the biggest burdens of disease on the economy of developing countries. There are only few studies on the prevalence and nature of psychiatric morbidity in Pakistan. The present study aims to describe the patterns of psychiatric morbidity and its correlates in a tertiary care teaching hospital. The details of all in-patient admissions from the case register developed for a health information system. The study was conducted in the Institute of Psychiatry and constituted data of four years [1996-1999]. A total of 2620 patients were admitted during these years. More male patients were admitted compared to female patients [59 percent vs. 41 percent]. The mean age of admission was 30.7 years for female and 31.7 years for males. Most patients were admitted with diagnosis of depressive illness [37 percent]; followed by bipolar affective disorder [11.40 percent], drug dependence [10.60 percent] and schizophrenia [8.40]. The patients with neurotic disorders were least likely to be admitted. It is concluded that the pattern of in-patient psychiatric morbidity is entirely different from the distribution of illness reported in the community. A psychiatric case register can be a useful source of data for research