International Journal of Behavioral Sciences Original Research

Need of a Comprehensive and Feasible Psychometric Test in the Assessment of Perinatal Mental Health - A Systematic Review

  1. Maj Anupa Devi Kairy Department of Perinatal Mental Health Therapist,Speakingcube 553-B, Tapkeshwar Colony, Garhi Cantt Dehradun
  2. Sneha Bharadwaj Department of Perinatal Mental Health Therapist,Speakingcube 553-B, Tapkeshwar Colony, Garhi Cantt Dehradun
  3. Kajal Tomar Department of Perinatal Mental Health Therapist,Speakingcube 553-B, Tapkeshwar Colony, Garhi Cantt Dehradun
  4. Dr. Deepika Chamoli Shahi Department of Perinatal Mental Health Therapist,Speakingcube 553-B, Tapkeshwar Colony, Garhi Cantt Dehradun

Abstract

The perinatal period is a period of happiness as well as hardships. A woman undergoes many psychological changes during this period which makes her prone to mental health disorders that can be detrimental to the health of the women and her child. Its essential to detect these disorders as early as possible and hence a psychometric test or tool which is easy to administer and interpret is needed. Globally various tools are available for use in perinatal period. The aim of this study is to assess the need of a comprehensive and feasible psychometric test in the assessment of perinatal mental health. We searched databases like Google scholar, PubMed, Web of Science, Springer, Elsevier. Research articles on various tools used in assessment of perinatal mental health disorders were reviewed. We have gone through 105 papers and identified 50 such articles which spoke about various tools used globally for screening perinatal mental health disorders for our systematic review. We reached the conclusion that there is no set standard for which tool to be used, time and frequency of administration and validation of tools to be used in various settings.

Keywords

References (50)

  1. Abrahams Z, Schneider M, Field S, Honikman S. Validation of a brief mental health screening tool for pregnant women in a low socio-economic setting. BMC Psychology. 2019;7(1). doi:10.1186/s40359-019-0355-3
  2. Adhikari K, Patten SB, Williamson T, Patel AB, Premji S, Tough S, et al. Assessment of anxiety during pregnancy: are existing multiple anxiety scales suitable and comparable in measuring anxiety during pregnancy? Journal of Psychosomatic Obstetrics & Gynecology. 2020;42(2):140-146. doi:10.1080/0167482x.2020.1725462
  3. Bhat A, Nanda A, Murphy L, Ball AL, Fortney J, Katon J. A systematic review of screening for perinatal depression and anxiety in community-based settings. Archives of Women's Mental Health. 2021;25(1):33-49. doi:10.1007/s00737-021-01151-2
  4. Chan AW, Reid C, Skeffington P, Marriott R. A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective. Archives of Women's Mental Health. 2020;24(3):353-365. doi:10.1007/s00737-020-01084-2
  5. Chen C, Okubo R, Okawa S, Nakagawa S, Tabuchi T. The diagnostic accuracy of the Edinburgh Postnatal Depression Scale without the self-harm item. Journal of Psychiatric Research. 2023;165:70-76. doi:10.1016/j.jpsychires.2023.07.015
  6. Cox J. Use and misuse of the Edinburgh Postnatal Depression Scale (EPDS): a ten point ‘survival analysis’. Archives of Women's Mental Health. 2017;20(6):789-790. doi:10.1007/s00737-017-0789-7
  7. Cox J. Thirty years with the Edinburgh Postnatal Depression Scale: voices from the past and recommendations for the future. The British Journal of Psychiatry. 2019;214(3):127-129. doi:10.1192/bjp.2018.245
  8. El-Den S, Pham L, Anderson I, Yang S, Moles RJ, O’Reilly CL, et al. Perinatal depression screening: a systematic review of recommendations from member countries of the Organisation for Economic Co-operation and Development (OECD). Archives of Women's Mental Health. 2022;25(5):871-893. doi:10.1007/s00737-022-01249-1
  9. Fairbrother N, Albert A, Keeney C, Tchir D, Cameron RB. Screening for Perinatal OCD: A Comparison of the DOCS and the EPDS. Assessment. 2021;30(4):1028-1039. doi:10.1177/10731911211063223
  10. Fairbrother N, Corbyn B, Thordarson DS, Ma A, Surm D. Screening for perinatal anxiety disorders: Room to grow. Journal of Affective Disorders. 2019;250:363-370. doi:10.1016/j.jad.2019.03.052
  11. Fijean AL, Marçais M, Banasiak C, Morel O, Dahlhoff S, Olieric MF, et al. Universal screening of postpartum depression with Edinburgh Postpartum Depression Scale: A prospective observational study. International Journal of Gynecology & Obstetrics. 2024;167(2):758-764. doi:10.1002/ijgo.15722
  12. Gomà M, Gordo L, Cozodoy E, Iriarte L, Prims E, Ferrer J, et al. Validation of the anxiety subscale of the Spanish version of the Edinburgh Postnatal Depression Scale (EPDS-A). Frontiers in Psychiatry. 2023;14. doi:10.3389/fpsyt.2023.1294206
  13. Green EP, Tuli H, Kwobah E, Menya D, Chesire I, Schmidt C. Developing and validating a perinatal depression screening tool in Kenya blending Western criteria with local idioms: A mixed methods study. Journal of Affective Disorders. 2018;228:49-59. doi:10.1016/j.jad.2017.11.027
  14. Gyimah L, Agyepong IA, Owiredu D, Awini E, Yevoo LL, Ashinyo ME, et al. Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa: systematic review. Frontiers in Public Health. 2024;12. doi:10.3389/fpubh.2024.1321689
  15. Heller HM, Draisma S, Honig A. Construct Validity and Responsiveness of Instruments Measuring Depression and Anxiety in Pregnancy: A Comparison of EPDS, HADS-A and CES-D. International Journal of Environmental Research and Public Health. 2022;19(13):7563. doi:10.3390/ijerph19137563
  16. National Institute of Mental Health, Klecany, Czech Republic, Horáková A, Nosková E, Švancer P, Marciánová V, Koliba P, et al. Accuracy of the Edinburgh Postnatal Depression Scale in screening for major depressive disorder and other psychiatric disorders in women towards the end of their puerperium. Česká gynekologie. 2022;87(1):19-26. doi:10.48095/cccg202219
  17. Johnson A, Stevenson E, Moeller L, McMillian‐Bohler J. Systematic Screening for Perinatal Mood and Anxiety Disorders to Promote Onsite Mental Health Consultations: A Quality Improvement Report. Journal of Midwifery & Women's Health. 2021;66(4):534-539. doi:10.1111/jmwh.13215
  18. Kotz J, Marriott R, Reid C. The EPDS and Australian Indigenous women: A systematic review of the literature. Women and Birth. 2021;34(2):e128-e134. doi:10.1016/j.wombi.2020.02.007
  19. Koukopoulos A, Mazza C, De Chiara L, Sani G, Simonetti A, Kotzalidis GD, et al. Psychometric Properties of the Perinatal Anxiety Screening Scale Administered to Italian Women in the Perinatal Period. Frontiers in Psychiatry. 2021;12. doi:10.3389/fpsyt.2021.684579
  20. Kozinszky Z, Dudas RB. Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period. Journal of Affective Disorders. 2015;176:95-105. doi:10.1016/j.jad.2015.01.044
  21. Lasater ME, Beebe M, Warren NE, Winch PJ, Soucko F, Keita M, et al. Reliability and validity of a perinatal depression screening instrument in rural Mali. SSM - Mental Health. 2022;2:100059. doi:10.1016/j.ssmmh.2021.100059
  22. Lautarescu A, Victor S, Lau-Zhu A, Counsell SJ, Edwards AD, Craig MC. The factor structure of the Edinburgh Postnatal Depression Scale among perinatal high-risk and community samples in London. Archives of Women's Mental Health. 2021;25(1):157-169. doi:10.1007/s00737-021-01153-0
  23. Levis B, Negeri Z, Sun Y, Benedetti A, Thombs BD. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ. 2020:m4022. doi:10.1136/bmj.m4022
  24. Loyal D, Sutter AL, Rascle N. Screening Beyond Postpartum Depression: Occluded Anxiety Component in the EPDS (EPDS-3A) in French Mothers. Maternal and Child Health Journal. 2020;24(3):369-377. doi:10.1007/s10995-020-02885-8
  25. Marley JV, Kotz J, Engelke C, Williams M, Stephen D, Coutinho S, et al. Validity and Acceptability of Kimberley Mum’s Mood Scale to Screen for Perinatal Anxiety and Depression in Remote Aboriginal Health Care Settings. PLOS ONE. 2017;12(1):e0168969. doi:10.1371/journal.pone.0168969
  26. Martin CJ, Norris G, Martin CR. Midwives' role in screening for antenatal depression and postnatal depression. British Journal of Midwifery. 2020 Sep 2;28(9):666–72.
  27. Meijer J, Beijers C, van Pampus M, Verbeek T, Stolk R, Milgrom J, et al. Predictive accuracy of Edinburgh Postnatal Depression Scale assessment during pregnancy for the risk of developing postpartum depressive symptoms: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121(13):1604-1610. doi:10.1111/1471-0528.12759
  28. Mutiso VN, Musyimi CW, Tele A, Alietsi R, Andeso P, Ndetei DM. Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya. Transcultural Psychiatry. 2022;60(3):476-483. doi:10.1177/13634615211043764
  29. Pan Y, Xu J. Can EPDS and EPDS‐3A be used to replace GAD‐7 to screen the anxiety of pregnant women during pregnancy examination? International Journal of Gynecology & Obstetrics. 2023;164(3):902-911. doi:10.1002/ijgo.15053
  30. Park SH, Kim JI. Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2022;307(5):1331-1345. doi:10.1007/s00404-022-06525-0
  31. Perinatal OCD Screening & Screening Tools. https://iocdf.org/perinatal-ocd/for-clinical-providers/perinatal-ocd-screening-screening-tools/
  32. Qiu X, Wu Y, Sun Y, Levis B, Tian J, Boruff JT, et al. Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific Reports. 2023;13(1). doi:10.1038/s41598-023-29114-w
  33. Rondung E, Massoudi P, Nieminen K, Wickberg B, Peira N, Silverstein R, et al. Identification of depression and anxiety during pregnancy: A systematic review and meta‐analysis of test accuracy. Acta Obstetricia et Gynecologica Scandinavica. 2023;103(3):423-436. doi:10.1111/aogs.14734
  34. Rubertsson C, Börjesson K, Berglund A, Josefsson A, Sydsjö G. The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nordic Journal of Psychiatry. 2011;65(6):414-418. doi:10.3109/08039488.2011.590606
  35. Screening Protocol for Perinatal Mood and Anxiety Disorders for Primary Care Providers. https://hmhb-mt.org/wp-content/uploads/2020/01/Protocol-Document-Final-1.8.20.pdf
  36. Shrestha SD, Pradhan R, Tran TD, Gualano RC, Fisher JRW. Reliability and validity of the Edinburgh Postnatal Depression Scale (EPDS) for detecting perinatal common mental disorders (PCMDs) among women in low-and lower-middle-income countries: a systematic review. BMC Pregnancy and Childbirth. 2016;16(1). doi:10.1186/s12884-016-0859-2
  37. Simpson W, Glazer M, Michalski N, Steiner M, Frey BN. Comparative Efficacy of the Generalized Anxiety Disorder 7-Item Scale and the Edinburgh Postnatal Depression Scale as Screening Tools for Generalized Anxiety Disorder in Pregnancy and the Postpartum Period. The Canadian Journal of Psychiatry. 2014;59(8):434-440. doi:10.1177/070674371405900806
  38. Slavin V, Creedy DK, Gamble J. Comparison of screening accuracy of the Patient Health Questionnaire-2 using two case-identification methods during pregnancy and postpartum. BMC Pregnancy and Childbirth. 2020;20(1). doi:10.1186/s12884-020-02891-2
  39. Smith-Nielsen J, Egmose I, Wendelboe KI, Steinmejer P, Lange T, Vaever MS. Can the Edinburgh Postnatal Depression Scale-3A be used to screen for anxiety? BMC Psychology. 2021;9(1). doi:10.1186/s40359-021-00623-5
  40. Stefana A, Mirabella F, Gigantesco A, Camoni L, for the Perinatal Mental Health Nework, Aceti F, et al. The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women. Journal of Psychosomatic Obstetrics & Gynecology. 2024;45(1). doi:10.1080/0167482x.2024.2404967
  41. Tanuma-Takahashi A, Tanemoto T, Nagata C, Yokomizo R, Konishi A, Takehara K, et al. Antenatal screening timeline and cutoff scores of the Edinburgh Postnatal Depression Scale for predicting postpartum depressive symptoms in healthy women: a prospective cohort study. BMC Pregnancy and Childbirth. 2022;22(1). doi:10.1186/s12884-022-04740-w
  42. Teissedre F, Chabrol H. A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: detection of mothers at risk for postpartum depression. The brain. 2004 Jul 1;30(4):376-81. https://doi.org/10.1016/s0013-7006(04)95451-6
  43. Usuda K, Nishi D, Okazaki E, Makino M, Sano Y. Optimal cut‐off score of the Edinburgh Postnatal Depression Scale for major depressive episode during pregnancy in Japan. Psychiatry and Clinical Neurosciences. 2017;71(12):836-842. doi:10.1111/pcn.12562
  44. van der Zee-van den Berg AI, Boere-Boonekamp MM, Groothuis-Oudshoorn CGM, Reijneveld SA. The Edinburgh Postpartum Depression Scale: Stable structure but subscale of limited value to detect anxiety. PLOS ONE. 2019;14(9):e0221894. doi:10.1371/journal.pone.0221894
  45. van Heyningen T, Myer L, Tomlinson M, Field S, Honikman S. The development of an ultra-short, maternal mental health screening tool in South Africa. Global Mental Health. 2019;6. doi:10.1017/gmh.2019.21
  46. Venkatesh KK, Kaimal AJ, Castro VM, Perlis RH. Improving discrimination in antepartum depression screening using the Edinburgh Postnatal Depression Scale. Journal of Affective Disorders. 2017;214:1-7. doi:10.1016/j.jad.2017.01.042
  47. Wang L, Kroenke K, Stump TE, Monahan PO. Screening for perinatal depression with the Patient Health Questionnaire depression scale (PHQ-9): A systematic review and meta-analysis. General Hospital Psychiatry. 2021;68:74-82. doi:10.1016/j.genhosppsych.2020.12.007
  48. Waqas A, Koukab A, Meraj H, Dua T, Chowdhary N, Fatima B, et al. Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence. BMC Psychiatry. 2022;22(1). doi:10.1186/s12888-022-03694-9
  49. Zhao Y, Kane I, Wang J, Shen B, Luo J, Shi S. Combined use of the postpartum depression screening scale (PDSS) and Edinburgh postnatal depression scale (EPDS) to identify antenatal depression among Chinese pregnant women with obstetric complications. Psychiatry Research. 2015;226(1):113-119. doi:10.1016/j.psychres.2014.12.016
  50. Zhong QY, Gelaye B, Rondon MB, Sánchez SE, Simon GE, Henderson DC, et al. Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Archives of Women's Mental Health. 2014;18(6):783-792. doi:10.1007/s00737-014-0481-0