Russell PSS, Chikkala SM, Earnest R, Viswanathan SA, Russell S, Mammen PM. Diagnostic accuracy and clinical utility of non-English versions of Edinburgh Post-Natal Depression Scale for screening post-natal depression in India: A meta-analysis. World J Psychiatr 2020; 10(4): 71-80 [PMID: 32399400 DOI: 10.5498/wjp.v10.i4.71]
Corresponding Author of This Article
Paul Swamidhas Sudhakar Russell, MBBS, MD, Professor, Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Bagayam, Vellore 632 002, India. russell@cmcvellore.ac.in
Research Domain of This Article
Psychiatry
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatr. Apr 19, 2020; 10(4): 71-80 Published online Apr 19, 2020. doi: 10.5498/wjp.v10.i4.71
Diagnostic accuracy and clinical utility of non-English versions of Edinburgh Post-Natal Depression Scale for screening post-natal depression in India: A meta-analysis
Paul Swamidhas Sudhakar Russell, Swetha Madhuri Chikkala, Richa Earnest, Shonima Aynipully Viswanathan, Sushila Russell, Priya Mary Mammen
Paul Swamidhas Sudhakar Russell, Swetha Madhuri Chikkala, Richa Earnest, Shonima Aynipully Viswanathan, Sushila Russell, Priya Mary Mammen, Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore 632 002, India
Author contributions: Russell PSS and Chikkala SW contributed equally to this work; Russell PSS and Chikkala SM conceived and designed the study; Chikkala SM and Earnest R did the literature search and collected data; Russell S and Viswanathan SA extracted the data; Viswanathan SA and Mammen PM appraised the quality of the studies; Russell PSS resolved the conflicts in data synthesis; Russell PSS did the statistical analyses; all authors contributed to the writing and approval of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors prepared the research paper after reading the PRSIMA checklist 2009.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Paul Swamidhas Sudhakar Russell, MBBS, MD, Professor, Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Bagayam, Vellore 632 002, India. russell@cmcvellore.ac.in
Received: December 26, 2019 Peer-review started: December 26, 2019 First decision: February 19, 2020 Revised: March 3, 2020 Accepted: March 25, 2020 Article in press: March 25, 2020 Published online: April 19, 2020
ARTICLE HIGHLIGHTS
Research background
Various language versions of Edinburgh Postnatal Depression (EPDS) have been validated in India. The summary global diagnostic accuracy and clinical utility of these versions was established.
Research motivation
The diagnosis of postnatal depression (PND) is often missed or misdiagnosed. This affects both the mother and the baby, with significant morbidity. The widely used EPDS in India has to be proven for the early identification of PND.
Research objectives
The aim of this meta-analysis was to document the summary diagnostic accuracy and clinical utility of the various language versions of EPDS in India.
Research methods
Seven studies were included in the analysis following the PRISMA guidelines. We used Area Under the Characteristic Curve of the Hierarchical Summary Receiver Operating Curve, with random effect model, to summarize the diagnostic accuracy of EPDS; Fagan’s nomogram was used for calculating clinical utility.
Research results
The global diagnostic accuracy of EPDS, as ascertained by Area Under the Characteristic Curve of the Hierarchical Summary Receiver Operating Curve, was 0.97 (95%CI: 0.95-0.98). For a PND prevalence of 22%, the positive post-test probability was 72% (95%CI: 68%, 76%) and the negative post-test probability was 2% (95%CI: 1%, 3%).
Research conclusions
We established the summary global diagnostic accuracy and clinical utility of the various versions of EPDS. The EPDS is effective in the early identification of PND.
Research perspectives
The EPDS in its various versions in India could be used for the scaling-up of PND treatment. The specific diagnostic parameters need to be further studied.
