Screening for postnatal depression: are specific instruments mandatory?

Background: Few studies have examined the utility of rating scales develope d in non-puerperal context in detecting postnatal depression. This study ev aluated the utility of the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) in screening for depression among recently deliv ered women in Hong Kong. Methods: A prospective cohort of 145 Chinese women completed the GHQ, BDI and Edinburgh Postnatal Depression Scale (EPDS) 6 w eeks after delivery. They were then assessed using the non-patient version of the Structured Clinical Interview for DSM-III-R (SCID-NP) to establish p sychiatric diagnosis, against which the criterion validity of the GHQ and B DI was evaluated against this clinical diagnosis. The psychometric performa nce of the GHQ, BDI and EPDS in detecting postnatal depression was assessed using the receiver operating characteristic (ROC) curves. Results: Both Ch inese GHQ and BDI had satisfactory sensitivity and positive predictive valu e in detecting postnatal depression. Their receiver operating characteristi c (ROC) curves were comparable to that of the EPDS. Limitation: The study w as conducted in Chinese women using translated version of the rating scales . Conclusions: The GHQ and BDI are useful for detecting postnatal depressio n among recently delivered Chinese women. The results of this study suggest that rating scales developed in non-puerperal context may also be applicab le for postnatal depression. (C) 2001 Elsevier Science B.V. All rights rese rved.