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Reliability and Validity of Instruments for Assessing Perinatal Depression in African Settings: Systematic Review and Meta-Analysis

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  • Alexander C Tsai
  • Jennifer A Scott
  • Kristin J Hung
  • Jennifer Q Zhu
  • Lynn T Matthews
  • Christina Psaros
  • Mark Tomlinson

Abstract

Background: A major barrier to improving perinatal mental health in Africa is the lack of locally validated tools for identifying probable cases of perinatal depression or for measuring changes in depression symptom severity. We systematically reviewed the evidence on the reliability and validity of instruments to assess perinatal depression in African settings. Methods and Findings: Of 1,027 records identified through searching 7 electronic databases, we reviewed 126 full-text reports. We included 25 unique studies, which were disseminated in 26 journal articles and 1 doctoral dissertation. These enrolled 12,544 women living in nine different North and sub-Saharan African countries. Only three studies (12%) used instruments developed specifically for use in a given cultural setting. Most studies provided evidence of criterion-related validity (20 [80%]) or reliability (15 [60%]), while fewer studies provided evidence of construct validity, content validity, or internal structure. The Edinburgh postnatal depression scale (EPDS), assessed in 16 studies (64%), was the most frequently used instrument in our sample. Ten studies estimated the internal consistency of the EPDS (median estimated coefficient alpha, 0.84; interquartile range, 0.71-0.87). For the 14 studies that estimated sensitivity and specificity for the EPDS, we constructed 2 x 2 tables for each cut-off score. Using a bivariate random-effects model, we estimated a pooled sensitivity of 0.94 (95% confidence interval [CI], 0.68-0.99) and a pooled specificity of 0.77 (95% CI, 0.59-0.88) at a cut-off score of ≥9, with higher cut-off scores yielding greater specificity at the cost of lower sensitivity. Conclusions: The EPDS can reliably and validly measure perinatal depression symptom severity or screen for probable postnatal depression in African countries, but more validation studies on other instruments are needed. In addition, more qualitative research is needed to adequately characterize local understandings of perinatal depression-like syndromes in different African contexts.

Suggested Citation

  • Alexander C Tsai & Jennifer A Scott & Kristin J Hung & Jennifer Q Zhu & Lynn T Matthews & Christina Psaros & Mark Tomlinson, 2013. "Reliability and Validity of Instruments for Assessing Perinatal Depression in African Settings: Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    • Handle: RePEc:plo:pone00:0082521
    DOI: 10.1371/journal.pone.0082521
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    1. L.R. Arends & T.H. Hamza & J.C. van Houwelingen & M.H. Heijenbrok-Kal & M.G.M. Hunink & T. Stijnen, 2008. "Bivariate Random Effects Meta-Analysis of ROC Curves," Medical Decision Making, , vol. 28(5), pages 621-638, September.
    2. Bandy Lee & Sylvia F. Kaaya & Jessie K. Mbwambo & Mary C. Smith-Fawzi & Melkizedek T. Leshabari, 2008. "Detecting Depressive Disorder With the Hopkins Symptom Checklist-25 in Tanzania," International Journal of Social Psychiatry, , vol. 54(1), pages 7-20, January.
    3. Mark Tomlinson & Crick Lund, 2012. "Why Does Mental Health Not Get the Attention It Deserves? An Application of the Shiffman and Smith Framework," PLOS Medicine, Public Library of Science, vol. 9(2), pages 1-4, February.
    4. Sylvia F. Kaaya & Bandy Lee & Jessie K. Mbwambo & Mary C. Smith-Fawzi & Melkizedek T. Leshabari, 2008. "Detecting Depressive Disorder With a 19-Item Local Instrument in Tanzania," International Journal of Social Psychiatry, , vol. 54(1), pages 21-33, January.
    5. Mark Tomlinson & Mary Jane Rotheram-Borus & Leslie Swartz & Alexander C Tsai, 2013. "Scaling Up mHealth: Where Is the Evidence?," PLOS Medicine, Public Library of Science, vol. 10(2), pages 1-5, February.
    6. Victoria K Ngo & Adolfo Rubinstein & Vijay Ganju & Pamela Kanellis & Nasser Loza & Cristina Rabadan-Diehl & Abdallah S Daar, 2013. "Grand Challenges: Integrating Mental Health Care into the Non-Communicable Disease Agenda," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-5, May.
    7. Patel, Vikram, 1995. "Explanatory models of mental illness in sub-Saharan Africa," Social Science & Medicine, Elsevier, vol. 40(9), pages 1291-1298, May.
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