Screening for depression in the postpartum using the Beck Depression Inventory II: What logistic regression reveals

Abstract

Objective: To identify items on the Beck Depression Inventory-II (BDI-II) that best discriminate between clinically depressed and nondepressed postpartum women. Background: Postpartum depression is a serious and widespread health burden, and the BDI-II is commonly used to detect depression in the postpartum. Yet certain depressive symptoms are ‘normative’ sequelae of childbirth, calling into question the discriminative utility of the BDI-II. Methods: We examined the prospective contribution of BDI-II items to identify items that have the strongest relation with clinical postpartum depression. Women with BDI-II scores >12 were invited to participate in a structured clinical interview. A logistic regression was conducted to determine which BDI-II items discriminated between women who were later diagnosed as Depressed (n = 75) and Nondepressed (n = 78). Results: Of the 11 BDI-II items that differed between the two groups, eight represented cognitive/affective symptoms. Results from the logistic regression indicated that four BDI-II symptoms were significant predictors of Depression status: sadness, pessimism, loss of interest, and changes in appetite. Conclusion: The BDI-II should be used in the postpartum with caution. Professionals who screen for postpartum depression should pay particular attention to cognitive/affective symptoms, as they appear more robust to normative physical and emotional changes that occur in the postpartum.

Keywords:

• Postpartum depression
• Beck Depression Inventory-II
• screening

Acknowledgements

We thank the parents and children who have repeatedly given their time and effort to participate in this research. We also thank Elizabeth R. Schwall, Aaron Rakow and Lynsay Ayer for participant recruitment and data collection. This research was supported by the Intramural Research Program of the NIH, NICHD. This study was also supported by a National Research Service Award from the National Institute on Drug Abuse F32DA032175 (to EC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute of Child Health and Human Development, or the National Institutes of Health.

Funding for this study was provided by the National Institute of Child Health and Human Development; the funding agency had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit this paper for publication.

Notes

This work was authored as part of the Contributor’s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law