title: Post-partum depression in Kinshasa, Democratic Republic of Congo: validation of a concept using a mixed-methods cross-cultural approach.
abstract: OBJECTIVE
  To determine if a post-partum depression syndrome exists among mothers in Kinshasa, Democratic Republic of Congo, by adapting and validating standard screening instruments.
  
  
  METHODS
  Using qualitative interviewing techniques, we interviewed a convenience sample of 80 women living in a large peri-urban community to better understand local conceptions of mental illness. We used this information to adapt two standard depression screeners, the Edinburgh Post-partum Depression Scale and the Hopkins Symptom Checklist. In a subsequent quantitative study, we identified another 133 women with and without the local depression syndrome and used this information to validate the adapted screening instruments.
  
  
  RESULTS
  Based on the qualitative data, we found a local syndrome that closely approximates the Western model of major depressive disorder. The women we interviewed, representative of the local populace, considered this an important syndrome among new mothers because it negatively affects women and their young children. Women (n = 41) identified as suffering from this syndrome had statistically significantly higher depression severity scores on both adapted screeners than women identified as not having this syndrome (n = 20; P < 0.0001).
  
  
  CONCLUSIONS
  When it is unclear or unknown if Western models of psychopathology are appropriate for use in the local context, these models must be validated to ensure cross-cultural applicability. Using a mixed-methods approach we found a local syndrome similar to depression and validated instruments to screen for this disorder. As the importance of compromised mental health in developing world populations becomes recognized, the methods described in this report will be useful more widely.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. jbass@jhsph.edu
authors.forename: Judith K
authors.initials: JK
authors.lastname: Bass
authors.forename: Robert W
authors.initials: RW
authors.lastname: Ryder
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Lammers
authors.forename: Thibaut N
authors.initials: TN
authors.lastname: Mukaba
authors.forename: Paul A
authors.initials: PA
authors.lastname: Bolton
mesh_terms: D003431:Cross-Cultural Comparison; D015023:Democratic Republic of the Congo; D019052:Depression, Postpartum / Q000175:diagnosis*; D003906:Developing Countries; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D014505:Urban Population