title: Different cutoff points for different trimesters? The use of Edinburgh Postnatal Depression Scale and Beck Depression Inventory to screen for depression in pregnant Taiwanese women.
abstract: OBJECTIVE
  Validating self-reported questionnaires to detect depression during pregnancy, compared to depression during postpartum, has gained much less attention. Furthermore, it is unknown whether it is appropriate to use the same cutoff point to detect depression on different trimesters of pregnancy. The aims of this study, conducted in pregnant Taiwanese women, were: (a) to validate the Taiwanese version of the Edinburgh Postnatal Depression Scale (EPDS-T) and the second edition of the Beck Depression Inventory (BDI-II); (b) to compare the EPDS-T and the BDI-II on their validity in detecting depression; and (c) to determine if these scales have different cutoff points in detecting major depressive disorder for different trimesters.
  
  
  METHODS
  One hundred eighty-five pregnant Taiwanese women who completed the EPDS-T and the BDI-II were interviewed by psychiatrists with the structural interview Mini-International Neuropsychiatric Interview (MINI) to establish a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of major depressive disorder. We analyzed and compared the sensitivity, specificity and validity of the EPDS-T and the BDI-II against the MINI diagnosis on the second and third trimesters.
  
  
  RESULTS
  We identified 12/13 as the optimal cutoff of the EPDS-T, at which the sensitivity of the scale was 83% and the specificity was 89%. The optimal cutoff of the BDI-II was 11/12, at which the sensitivity of the scale was 74% and the specificity was 83%. The area under the curve of the receiver operating characteristic analysis was 0.92 for the EPDS-T and 0.84 for the BDI. There exist different optimal cutoff points of the EPDS-T for detecting major depression during different trimesters: 13/14 for the second trimester and 12/13 for the third trimester. No different optimal cutoff point for the BDI-II was found for different trimesters.
  
  
  CONCLUSIONS
  The EPDS-T has satisfactory sensitivity and specificity and better validity than the BDI-II for detecting major depressive disorder during pregnancy in pregnant Taiwanese women. We suggest that more studies with larger sample sizes be performed to confirm if there exist different cutoff points in detecting depression for different trimesters of gestation.
authors: Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan. cobolsu@gmail.com
authors: Kuan-Pin
authors: KP
authors: Su
authors: Tsan-Hung
authors: TH
authors: Chiu
authors: Chieh-Liang
authors: CL
authors: Huang
authors: Ming
authors: M
authors: Ho
authors: Chieh-Chung
authors: CC
authors: Lee
authors: Po-Lun
authors: PL
authors: Wu
authors: Cher-Yeang
authors: CY
authors: Lin
authors: Chun-Hui
authors: CH
authors: Liau
authors: Chin-Chih
authors: CC
authors: Liao
authors: Wei-Che
authors: WC
authors: Chiu
authors: Carmine M
authors: CM
authors: Pariante
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D019052:Depression, Postpartum / Q000453:epidemiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods*; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000523:psychology*; D011446:Prospective Studies; D011594:Psychometrics; D011795:Surveys and Questionnaires; D013624:Taiwan