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 stuReport as inadecuate




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 stu - Download this document for free, or read online. Document in PDF available to download.

BMC Psychiatry

, 14:303

Mood disorders

Abstract

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

MethodsWe 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.

Results35.8% 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.

ConclusionsThe 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.

KeywordsPregnancy Major depression Prenatal depression Uganda Africa Screening AbbreviationsANCAntenatal care

AUROCArea under the receiver operating characteristic curve

CES-DCenter for epidemiologic studies- depression scale

GBDGlobal burden of disease

GRRHGulu Regional Referral Hospital

MDDMajor depressive disorder

MINI-DMini-international neuropsychiatric interview- depression module

PMTCTPrevention of mother to child transmission of HIV

PPVPositive predictive values

PreNAPsPrenatal nutrition and psychosocial health outcomes study

SeSensitivity

SpSpecificity

SSASub-Saharan Africa

WHOWorld Health Organisation

Electronic supplementary materialThe online version of this article doi:10.1186-s12888-014-0303-y contains supplementary material, which is available to authorized users.

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Author: Barnabas K Natamba - Jane Achan - Angela Arbach - Thomas O Oyok - Shibani Ghosh - Saurabh Mehta - Rebecca J Stoltzfus -

Source: https://link.springer.com/







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