A cross-cultural analysis of the use of the Edinburgh Post-Natal Depression Scale (EPDS) in health visiting practice

This report describes a project that developed and undertook initial valida tion of a Punjabi version of the Edinburgh Post-Natal Depression Scale (EPD S). A multi-disciplinary and multi-ethnic project team translated the EPDS from English to Punjabi. A pilot study indicated a high level of correlatio n between the two scales opening the way for a larger study in which a tota l of 98 bi-lingual women completed both the English and Punjabi version of the scale 6-8 weeks after delivery of their child. Of these a further 52 co mpleted the scales on a second occasion, 16-18 weeks post-partum. A small s ub-group (n = 15) was subject to independent clinical assessment by a commu nity psychiatric nurse (CPN) to determine their mental state, enabling the outcome of the assessment to be compared with the EPDS score. The scores of the English and Punjabi versions of the scale were analysed using Spearman correlation coefficient and the Bland Altman test. A high correlation was found between overall scores and most individual items on the scale. Furthe rmore, the independent assessment of mental health state indicated that a n umber of those women who scored 12 or above on the EPDS scale (the cut-off point for determining risk of post-natal depression (PND)) were diagnosed a s having a post-natal depressive disorder by the CPN assessing them indepen dently. Whilst the results to date are promising there is a need for furthe r work to determine the validity, sensitivity and specificity of the Punjab i EPDS tool against international classification of depressive disorders an d to establish optimal cut-off scores when using the Punjabi version of the EPDS.