Atif Rahman, Zafar Iqbal, Hermione Lovel, Mohammad Alam Shah.
Screening for postnatal depression in the developing world: a comparison of the WHO Self-Reporting Questionnaire (SRQ-20) and the Edinburgh Postnatal Depression Screen (EPDS).
J Pak Psych Soc Jan ;2(2):69-72.

Objectives: This study was conducted to compare the suitability, usefulness, and validity of the Self Reporting Questionnaire (SRQ-20) and the Edinburgh Postnatal Depression Scale (EPDS) for screening postnatal depression in a mostly non-literate, rural, postnatal population of Pakistani women. Design: Comparative Study. Place and Duration of Study: Ten union councils of Southern Kahuta, a rural sub-district of Rawalpindi, Pakistan during January to September 2002 (a total of nine months). Subjects And Methods: Translation and cultural adaptation of all instruments was carried out using a rigorous seven-step procedure. A total of 541 women were administered the SRQ-20 and EPDS by trained health workers, and later interviewed with WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Receiver Operating Curve (ROC) analysis was undertaken. Results: ROC curves for the SRQ show values for the ROC area under the curve of 0.82 (95% CI: 0.78 to 0.86). The corresponding values for EPDS are 0.84 (95% CI: 0.81 to 0.88). The effects of varying cut-off points on the sensitivity, specificity, and positive predictive value are described. Conclusion: This study shows that when used by trained health workers after cultural adaptation, the SRQ-20 is equally effective as EPDS in screening for postnatal depression. The health workers preferred to use the SRQ-20 with non-literate women because of its simpler format.

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