title: A comparison of three screening tools to identify perinatal depression among low-income African American women.
abstract: BACKGROUND
  The purpose of the current study was to determine the sensitivity, specificity, and positive predictive value of three depression screening tools among a low-income African American population of pregnant and recently delivered women enrolled in home visitation programs in a low-income urban community.
  
  
  METHODS
  Ninety-five women enrolled in home visitation programs-32 who were pregnant and 63 with a child <6 months comprise the study sample. Each woman completed a structured clinical interview and three depression screening tools-the Edinburgh Postnatal Depression Scale (EPDS), Center for Epidemiologic Studies Depression Scale (CES-D), and Beck Depression Inventory II (BDI-II).
  
  
  RESULTS
  Over a quarter of women (28.4%) were experiencing major depression. Each screening tool was highly accurate in detecting major depression and major or minor depression among prenatal and postpartum women, with areas under the curve (AUCs) >0.90. Sensitivities of all screening tools were improved when using cutoffs lower than those considered standard by instrument developers.
  
  
  CONCLUSIONS
  Participants were recruited from home visitation programs in an urban context which may limit generalizability to other populations of low-income African American women. Given that no women during pregnancy met criteria for minor depression, it was not possible to determine optimal prenatal cutoff scores.
  
  
  CONCLUSIONS
  Three depression screening tools-the EPDS, CES-D, and BDI-II-appear to be reliable and brief assessments of major and minor depression among low-income African American perinatal women. Providers using these tools should consider using lower cutoff scores to most effectively identify women in need of depression treatment.
authors.affiliation: Johns Hopkins University School of Medicine, United States. Electronic address: standon@jhmi.edu.
authors.forename: S Darius
authors.initials: SD
authors.lastname: Tandon
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, United States.
authors.forename: Fallon
authors.initials: F
authors.lastname: Cluxton-Keller
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, United States.
authors.forename: Julie
authors.initials: J
authors.lastname: Leis
authors.affiliation: George Washington University, Department of Psychology, United States.
authors.forename: Huynh-Nhu
authors.initials: HN
authors.lastname: Le
authors.affiliation: Georgetown University Center for Child and Human Development, United States.
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Perry
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D019052:Depression, Postpartum / Q000175:diagnosis / Q000208:ethnology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000208:ethnology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D006792:House Calls; D006801:Humans; D008403:Mass Screening; D058725:Peripartum Period; D011203:Poverty; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000208:ethnology; D011569:Psychiatric Status Rating Scales; D014505:Urban Population; D055815:Young Adult