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]

ABSTRACT

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