VALIDATING THE MYANMAR VERSION OF THE EDINBURGH POSTNATAL DEPRESSION SCALE AS A SCREENING TOOL FOR POSTPARTUM DEPRESSION

Okkar Aung1, Nopporn Howteerakul1, Nawarat Suwannapong2, Natkamol Chansatitporn3, and Siriwan Tangjitgamol4

Abstract

The Edinburgh Postnatal Depression Scale is a tool designed to detect postpartum depression (PD) and has been validated in several countries, but not in Myanmar. This study aimed to validate the Myanmar version of the Edinburgh Postnatal Depression Scale (M-EPDS) as a screening tool to detect PD among postpartum mothers in Bago Township, where the women’s sociodemographic characteristics are similar to the majority of Myanmar women. A cohort of 332 postpartum mothers at 6-8 weeks, aged 18 years and over, able to read and write the Myanmar language, and willing to give informed consent were prospectively recruited and assessed using a self-reported M-EPDS at an outpatient department of a public hospital, and clinically interviewed for DSM-5 (SCID) diagnosis of minor or major depressions by a psychiatrist at a private clinic. The prevalence of PD according to M-EPDS was 19.9% (66/332), whereas 9 (2.7%) were diagnosed with major depression, and 24 (7.2%) with minor depression by DSM-5 criteria. The reliability of M-EPDS was satisfactory, Cronbach’s alpha was 0.804. The optimal cut-off score for major depression was 10/11, with a sensitivity of 100.0%, specificity of 82.4%, positive predictive value (PPV) of 13.6%, negative predictive value (NPV) of 100.0% and accuracy (area under curve) of 94.7%. The optimal cut-off score for combined depression was 8/9, with a sensitivity of 90.9%, specificity of 67.2%, PPV of 23.4%, NPV of 98.5% and accuracy of 84.5%. The M-EPDS is an acceptable tool for screening PD in Myanmar where no other PD screening tool is available.