A silent health crisis in the United States is the underdiagnosed and undertreated mental health of women related to childbirth. This discussion paper describes the Postpartum Depression Screening Scale (PDSS) with its scoring and interpretation along with its psychometric testing and translations.
METHOD:
In addition to the studies conducted by the instrument developers, databases were searched for studies where other researchers used the PDSS to assess postpartum depressive symptoms. Studies were included that measured the psychometrics of the scale and studies that reported the translation of the PDSS into other languages.
RESULTS:
Evidence is presented that the PDSS is a reliable and valid screening scale for use by psychiatric mental health nurses and other health care providers. The scale also has been translated into 14 languages, so it is available to screen non-English speaking mothers.
CONCLUSION:
Childbirth is one of the most powerful triggers of psychiatric illness in a woman’s life. Postpartum depression is a treatable mental health condition, but first, women need to be screened so they can be identified and referrals made. Screening for this devastating mood disorder in new mothers is an essential role of psychiatric mental health nurses and other clinicians so that treatment can be started as early as possible to avoid harmful consequences.
BeckC. T.GableR. K. (2001a). Comparative analysis of the performance of the Postpartum Depression Screening Scale with two other depression instruments. Nursing Research, 50(4), 42–250. https://doi.org/10.1097/00006199-200107000-00008
8.
BeckC. T.GableR. K. (2001b). Ensuring content validity: An illustration of the process. Journal of Nursing Measurement, 9, 201–215.
9.
BeckC. T.GableR. K. (2001c). Further validation of the Postpartum Depression Screening Scale. Nursing Research, 50(3), 155–164.
10.
BeckC. T.GableR. K. (2001d). Item response theory in affective instrument development: An illustration. Journal of Nursing Measurement, 9, 5–22.
BeckC. T.GableR. K. (2005). Screening performance of the Postpartum Depression Screening Scale-Spanish Version. Journal of Transcultural Nursing, 16(4), 331–338. https://doi.org/10.1177/1043659605278940
13.
BeckC. T.KurzB.GableR. K. (2012). Concordance and discordance of the Postpartum Depression Screening Scale and Patient Health Questionnaire-9 in an ethnically diverse sample. Journal of Social Service Research, 38(4), 439–450. https://doi.org/10.1080/01488376.2012.680840
14.
BowerK. M.GellerR. J.JeffersN.McDonaldM.AlhusenJ. (2023). Experiences of racism and perinatal depression: Findings from the Pregnancy Risk Assessment Monitoring System. Journal of Advanced Nursing, 79(5), 1982–1993. https://doi.org/10.1111/jan.15519
15.
CantilinoA.CarvalhoJ. A.MaiaA.AlbuquerqueC.CantilinoG.Botelho SougeyE. (2007). Translation, validation and cultural aspects of Postpartum Depression Screening Scale in Brazilian Portuguese. Transcultural Psychiatry, 44(4), 672–684. https://doi.org/10.1177/1363461507083904
16.
ClarkeP. J. (2008). Validation of two Postpartum Depression Screening Scales with a sample of First Nations and Métis women. Canadian Journal of Nursing Research, 40(1), 112–125.
17.
CoxJ. L.HoldenJ. M.SagovskyR. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782
18.
DagherR. K.Pérez-StableE. J.JamesR. S. (2021). Socioeconomic and racial/ethnic disparities in postpartum consultation for mental health concerns among US mothers. Archives of Women’s Mental Health, 24, 781–791. https://doi.org/10.1007/s00737-021-01132-5
19.
DudeneyE.ContesR.AyersS.McCabeR. (2023). Measures of suicidality in perinatal women: A systematic review. Journal of Affective Disorders, 324, 210–231. https://doi.org/10.1016/j.jad.2022.12.091
20.
HegedusK. S.BeckC. T. (2012). Development and psychometric testing of the Postpartum Depression Screening Scale: Hungarian version. International Journal of Human Caring, 16, 154–158. https://doi.org/10.20467/1091-5710.16.1.54
21.
JesterJ. M.RiggsJ. L.MenkeR. A.AlfafaraE.IssaM.MuzikM.RosenblumK. L. (2023). Randomized pilot trial of the “Mom Power” trauma-and-attachment-informed multi-family group intervention in treating and preventing postpartum symptoms of depression among a health disparity sample. Frontiers in Psychiatry, 14, 1048511. https://doi.org/10.3389/fpsyt.2023.1048511
22.
KaracamZ.KitisY. (2008). The Postpartum Depression Screening Scale: Its reliability and validity for the Turkish population. Turkish Journal of Psychiatry, 19(2), 187–196.
23.
KimT. H. M.Delahunty-PikeA.Campbell-YeoM. (2020). Effect of fathers’ presence and involvement in newborn care in the NICU on mothers’ symptoms of postpartum depression. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 49(5), 452–463. https://doi.org/10.1016/j.jogn.2020.05.007
24.
KossakowskaK. (2012). A Polish adaptation and psychometric evaluation of the Postpartum Depression Screening Scale (PDSS) for depressing symptoms and signs of postnatal depression. Advances in Psychiatry and Neurology, 21(2), 123–129.
25.
LaraM. A.NavarreteL.NavarroC.LeH. N. (2013). Evaluation of the psychometric measures for the Postpartum Depression Screening Scale–Spanish version for Mexican women. Journal of Transcultural Nursing, 24(4), 378–386. https://doi.org/10.1177/1043659613493436
26.
LeH. N.PerryD. F.OrtizG. (2010). Postpartum Depression Screening Scale-Spanish version: Examining the psychometric properties and prevalence of risk for postpartum depression. Journal of Immigrant and Minority Health, 12(2), 249–258. https://doi.org/10.1007/s10903-009-9260-9
27.
LeH. N.PerryD. F.ShengX. (2009). Using the Internet to screen for postpartum depression. Maternal Child Health Journal, 13(2), 213–221. https://doi.org/10.1007/s10995-008-0322-8
28.
LiJ.YinJ.WaqasA.HuangZ.ZhangH.ChinM.GuoY.RahmanA.YangL.LiX. (2022). Quality of life in mothers with perinatal depression: A systematic review and meta-analysis. Frontiers in Psychiatry, 13, 734836. https://doi.org/10.3389/fpsyt.2022.734836
29.
LiuX.WangS.WangG. (2022). Prevalence and risk factors of postpartum depression in women: A systematic review and meta-analysis. Journal of Clinical Nursing, 31(19–20), 2665–2677. https://doi.org/10.1111/jocn.16121
30.
MentoC.LombardoC.MoscatelloM. R. A.FormicaI.CedroC.PandolfoG.ZoccaliR. A.BrunoA. (2022). Which role for trait-anxiety in paternal perinatal depression? Preliminary results on healthy subjects. The Journal of Maternal-Fetal and Neonatal Medicine, 35(13), 2445–2449. https://doi.org/10.1080/14767058.2020.1786514
31.
MitchellA. E.MittelstaedtM. E.Schott-BaerD. (2006). Postpartum depression: The reliability of telephone screening. MCN: American Journal of Maternal Child Nursing, 31(6), 382–387. https://doi.org/10.1097/00005721-200611000-00010
32.
PereiraA. T.BosS.MarquesM.MaiaB.SoaresM. J.ValenteJ.NogueiraV.de AzevedoM. H. P.MacedoA. (2013). Short forms of the Postpartum Depression Screening Scale: As accurate as the original form. Archives of Women’s Mental Health, 16, 167–177. https://doi.org/10.1007/s00737-012-0319-6
33.
PereiraA. T.BosS. C.MarquesM.MaiaB. R.SoaresM. J.ValenteJ.GomesA. A.MacedoA.de AzevedoM. H. P. (2011). The Postpartum Depression Screening Scale: Is it valid to screen for antenatal depression?Archives of Women’s Mental Health, 14(3), 227–238. https://doi.org/10.1007/s00737-010-0178-y
34.
PosmontierB. (2008). Sleep quality in women with and without postpartum depression. Journal of Obstetrics, Gynecologic, and Neonatal Nursing, 37(6), 722–737. https://doi.org/10.1111/j.1552-6909.2008.00298.x
35.
Postpartum Support International. (2020). Mind the gap: A strategic roadmap to address America’s silent health crisis: Untreated and unaddressed perinatal mental health disorders. Mind the Gap National Report. https://www.postpartum.net/mind-the-gap/
36.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurements, 1, 385–401.
37.
ShapiroA. F.JolleyS. N.HildebrandtU.SpiekerS. J. (2020). The effects of early postpartum depression on infant temperament. Early Child Development and Care, 190(12), 1918–1930. https://doi.org/10.1080/03004430.2018.1552947
38.
SidebottomA.VacquierM.LaRussoE.EricksonD.HardemanR. (2021). Perinatal depression screening practices in a large health system: Identifying current state and assessing opportunities to provide more equitable care. Archives of Women’s Mental Health, 24(1), 133–144. https://doi.org/10.1007/s00737-020-01035-x
39.
SlomianJ.HonvoG.EmontsP.ReginsterJ. Y.BruyéreO. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1–55. https://doi.org/10.1177/1745506519844044
40.
SpitzerR. L.KroenkeK.WilliamsJ. B. (1999). Validity and utility of a self-report version of PRIME-MD: The PHQ primary care study. JAMA, 282, 1737–1744.
41.
StevensonK.FellmethG.EdwardsE.CalvertC.BennettP.CampbellO. M. R.FuhrD. (2023). The global burden of perinatal common mental health disorders and substance use among migrant women: A systematic review and meta-analysis. Lancet Public Health, 8(3), e203–216. https://doi.org/10.1016/s2468-2667(22)00342-5
42.
VittayanontA.LiabsuetrakupT.PitanupongJ. (2006). Development of the Postpartum Depression Screening Scale (PDSS): Thai version for screening postpartum depression. Journal of the Medical Association of Thailand, 89(1), 1–7.
43.
VogeliJ. M.HookerS. A.EverhartK. D.KaplanP. S. (2018). Psychometric properties of the Postpartum Depression Screening Scale beyond the postpartum period. Research in Nursing and Health, 41(2), 185–194. https://doi.org/10.1002/nur.21861
44.
WenzelE. S.GibbonsR. D.O’HaraM. W.DuffecyJ.MakiP. M. (2021). Depression and anxiety symptoms across pregnancy and the postpartum in low-income Black and Latina women. Archives of Women’s Mental Health, 24(6), 979–986. https://doi.org/10.1007/s00737-021-01139-y
45.
WhiteG. (2008). A comparison of the Postpartum Depression Screening Scale (PDSS) with the Edinburgh Postnatal Depression Scale (EPDS). New Zealand College of Midwives Journal, 39, 16–32.
46.
ZhaoY.KaneI.WangJ.SheB.LuoJ.ShiS. (2015). Combined use of the Postpartum Depression Screening Scale (PDSS) and Edinburgh Postnatal Depression Scale (EPDS) to identify antenatal depression among Chinese pregnant women with obstetric complications. Psychiatry Research, 226, 1113–1119. https://doi.org/10.1016/j.psychres.2014.12.016
47.
ZhaoY.Munro-KramerM. L.ShiS.WangJ.ZhaoQ. (2019). Effects of antenatal depression screening and intervention among Chinese high-risk pregnant women with medically defined complications: A randomized controlled trial. Early Intervention in Psychiatry, 13(5), 1090–1098. https://doi.org/10.1111/eip.12731
48.
ZubaranC.SchumacherM. V.ForestiK.ThorellM. R.AmorettiA.MüllerL. (2010). The Portuguese version of the Postpartum Depression Screening Scale-short form. Journal of Obstetrics and Gynaecology Research, 36(5), 950–957. https://doi.org/10.1111/j.1447-0756.2010.01282.x
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
