Reliability and validity of the center for epidemiologic studies-depression scale in screening for depression among HIV-infected and -uninfected pregnant women attending antenatal services in northern Uganda: a cross-sectional study

BMC Psychiatry

Sera L Young¹  Jeffrey K Griffiths⁵  Rebecca J Stoltzfus¹  Saurabh Mehta¹  Shibani Ghosh³  Thomas O Oyok⁷  Angela Arbach⁶  Jane Achan⁴  Barnabas K Natamba² 

[1] Division of Nutritional Sciences, Cornell University, Ithaca 14853, NY, USA;PRENAPS Uganda, Kampala, Uganda;Friedman School of Nutrition Science and Policy, Tufts University, Boston 02155, MA, USA;Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda;Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston 02155, MA, USA;Weill Cornell Medical College, New York 10021, NY, USA;Department of Mental Health, Faculty of Medicine, Gulu University, Gulu, Uganda

关键词: Screening;    Africa;    Uganda;    Prenatal depression;    Major depression;    Pregnancy;   

Others  :  1092243
DOI  :  10.1186/s12888-014-0303-y

 received in 2014-05-29, accepted in 2014-10-16,  发布年份 2014

【 摘 要 】

Background

There are limited data on the prevalence and approaches to screening for depression among pregnant women living in resource poor settings with high HIV burden.

Methods

We studied the reliability and accuracy of the Center for Epidemiologic Studies Depression (CES-D) scale in 123 (36 HIV-infected and 87 -uninfected) pregnant women receiving antenatal care at Gulu Regional Referral Hospital, Uganda. CES-D scores were compared to results from the psychiatrist-administered Mini-International Neuropsychiatric Interview (MINI) for current major depressive disorder (MDD), a “gold standard” for assessing depression. We employed measures of internal consistency (Cronbach’s alpha), and criterion validity [Area Under the Receiver Operating Characteristic Curve (AUROC), sensitivity (Se), specificity (Sp), and positive predictive value (PPV)] to evaluate the reliability and validity of the CES-D scale.

Results

35.8% of respondents were currently experiencing an MDD, as defined from outputs of the MINI-depression module. The CES-D had high internal consistency (Cronbach’s alpha = 0.92) and good discriminatory ability in detecting MINI-defined current MDDs (AUROC = 0.82). The optimum CES-D cutoff score for the identification of probable MDD was between 16 and 17. A CES-D cutoff score of 17, corresponding to Se, Sp, and PPV values of 72.7%, 78.5%, and 76.5%, is proposed for adoption in this population and performs well for HIV-infected and -uninfected women. After adjusting for baseline differences between the HIV subgroups (maternal age and marital status), HIV-infected pregnant women scored 6.2 points higher on the CES-D than HIV-uninfected women (p = 0.032).

Conclusions

The CES-D is a suitable instrument for screening for probable major depression among pregnant women of mixed HIV status attending antenatal services in northern Uganda.

【 授权许可】

   
2014 Natamba et al.; licensee BioMed Central Ltd.

【 图 表 】

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