Validation of the Hindi version of the Edinburgh postnatal depression scale (EPDS): Translation, cross-cultural adaptation, and psychometric evaluation in postpartum mothers.
Postpartum depression (PPD) is a significant global public health concern, with a high prevalence in India. While the EPDS is widely used, there is a lack of rigorous validation studies specifically for Hindi-speaking postpartum mothers.
This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Hindi EPDS in postpartum mothers against a clinical diagnosis.
An observational study was conducted at a tertiary care hospital involving 181 mothers, 48 hours to 7 days after childbirth. The original English EPDS underwent a five-stage translation and adaptation process, including independent forward and back-translations and expert committee reviews. Validity was assessed against a clinical diagnosis made by a psychiatrist. Statistical analysis included Cronbach's alpha for internal consistency, Principal Axis Factoring with Promax rotation for construct validity, and receiver operating characteristic (ROC) curve analysis to determine the optimal cut-off score.
The prevalence of depression in the cohort was 26.0% (47/181). Hindi EPDS showed good internal consistency (Cronbach's α =0.859) and demonstrated good diagnostic accuracy with an Area Under the Curve (AUC) of 0.912. At an optimal cut-off score of 9, the scale showed a sensitivity of 70.2% and a specificity of 91.8%. Factor analysis revealed a three-factor structure: Anxiety, Depressed Affect, and Anhedonia, which accounted for 62% of the total variance.
The Hindi version of the EPDS is a valid, reliable, and culturally sensitive tool for screening postpartum depression in Indian tertiary care settings. A threshold score of nine is recommended for identifying at-risk mothers, enabling clinicians to apply cultural formulations for mothers facing significant neonatal stressors or breastfeeding difficulties.
This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Hindi EPDS in postpartum mothers against a clinical diagnosis.
An observational study was conducted at a tertiary care hospital involving 181 mothers, 48 hours to 7 days after childbirth. The original English EPDS underwent a five-stage translation and adaptation process, including independent forward and back-translations and expert committee reviews. Validity was assessed against a clinical diagnosis made by a psychiatrist. Statistical analysis included Cronbach's alpha for internal consistency, Principal Axis Factoring with Promax rotation for construct validity, and receiver operating characteristic (ROC) curve analysis to determine the optimal cut-off score.
The prevalence of depression in the cohort was 26.0% (47/181). Hindi EPDS showed good internal consistency (Cronbach's α =0.859) and demonstrated good diagnostic accuracy with an Area Under the Curve (AUC) of 0.912. At an optimal cut-off score of 9, the scale showed a sensitivity of 70.2% and a specificity of 91.8%. Factor analysis revealed a three-factor structure: Anxiety, Depressed Affect, and Anhedonia, which accounted for 62% of the total variance.
The Hindi version of the EPDS is a valid, reliable, and culturally sensitive tool for screening postpartum depression in Indian tertiary care settings. A threshold score of nine is recommended for identifying at-risk mothers, enabling clinicians to apply cultural formulations for mothers facing significant neonatal stressors or breastfeeding difficulties.
Authors
Begum Begum, Solanki Solanki, Basera Basera, Dabar Dabar, Halder Halder, Sutar Sutar
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