Postnatal depression among Sudanese women: prevalence and validation of the Edinburgh Postnatal Depression Scale at 3 months postpartum

Figures & data

Table 1 Distribution of variables among test positive women (n=20) and “all” test negative women (n=216)

Variable	No of test positives	No of test negatives
Educational level
Postgraduate	0	5
University	9	78
Secondary	5	62
Primary	6	66
No education	0	5
Parity
Primigravida	9	62
Multipra (1–4)	11	133
Grandmultipra (≥5)	0	21
Place of delivery
Health facility	20	198
Home delivery	0	18

Notes: Women are test positive for PND if they score ≥12 in the EPDS. Women are test negative for PND if they score <12 in the EPDS.

Abbreviations: EPDS, Edinburgh Postnatal Depression Scale; PND, Postnatal Depression.

Figure 1 Receiver operating characteristic analysis of the EPDS total score against the Arabic MINI interview for DSM-IV diagnosis of postpartum major depression.

Abbreviations: EPDS, Edinburgh Postnatal Depression Scale; MINI, Mini-International Neuropsychiatric Interview; ROC, receiver operator characteristic.

Table 2 EPDS T1 status vs MINI statusa

	MINI status		Total (N=40)
	Clinical depressed	Clinical not depressed
EPDS T1 status
Test positive
Count	16	4	20
Within MINI status	88.90%*	18.20%
Test negative
Count	2	18	20
Within MINI status	11.10%	81.80%**
Total
Count	18	22	40

Note:

a The kappa measure of agreement value =.7 (P-value <0.001).

* Indicates sensitivity of the EPDS.

** Indicates specificity of the EPDS.

Abbreviations: EPDS, Edinburgh Postnatal Depression Scale; MINI, Mini-International Neuropsychiatric Interview; vs, versus; T1, screening at 3 months postpartum.

Table 3 Range of EPDS cutoff scores and corresponding values of sensitivity, specificity, and predictive values in percentages (N=40)

Positive if equal or greater than	Sensitivity	Specificity	PPVa	NPVa	1 − Specificity (FPR)	NND
≥1	100	9.1	10	100	90.9	11
≥2	94.4	27.3	11.6	98	72.7	4.6
≥3	94.4	36.4	13.1	98.5	63.6	3.2
≥4	94.4	40.9	13.9	98.6	59.1	2.8
≥5	94.4	45.5	14.9	98.8	54.5	2.5
≥6	94.4	50	16	98.9	50	2.3
≥7	94.4	50	16	98.9	50	2.3
≥8	94.4	59.1	18.9	99	40.9	1.9
≥9	94.4	68.2	23.1	99.2	31.8	1.6
≥10	88.9	68.2	22.1	98.4	31.8	1.8
≥11	88.9	77.3	28.6	98.7	22.7	1.5
≥12	88.9	81.8	33.3	98.8	18.2	1.4
≥13	72.2	90.9	44.6	97	9.1	1.6
≥14	61.1	90.9	40.5	95.9	9.1	1.9
≥15	55.6	90.9	38.2	95.3	9.1	2.2

Note:

a At a prevalence of 9.2% for major depression. The bold indicates the psychometric properties (sensitivity, specificity, PPV, NPV, false positive rate and NND) of the EPDS compared to the MINI at a cut-off score ≥12.

Abbreviations: EPDS, Edinburgh Postnatal Depression Scale; FPR, false-positive rate; NND, number needed to diagnose; NPV, negative predictive value; PPV, positive predictive value.