The Validity of The Patient Health Questionnaire-2 As A Depression Screening Tool in Women Receiving Antenatal Care at Chelstone First Level Hospital, Lusaka, Zambia
The Validity of The Patient Health Questionnaire-2 As A Depression Screening Tool in Women Receiving Antenatal Care at Chelstone First Level Hospital, Lusaka, Zambia
Abstract
Background: The Patient Health Questionnaire-2 is frequently used as the first step in assessing people for major depressive disorder symptoms. However, its accuracy in correctly distinguishing between major depressive disorder cases and non-cases among pregnant women seeking prenatal care services in Zambia has not been studied. We set out to determine the validity of The Patient Health Questionnaire-2 as a brief screening tool for antenatal depression in pregnant women attending antenatal care services at Chelstone First Level Hospital in Lusaka, using the Edinburgh Postnatal Depression Scale as the gold standard. Method: We carried out a descriptive cross-sectional study and enrolled pregnant women who were receiving prenatal treatment at Chelstone First Level Hospital. The Patient Health Questionnaire -2 was used to screen 281 pregnant women, with the Edinburgh Postnatal Depression Scale (EPDS) serving as the gold standard. The Patient Health Questionnaire -2's concurrent validity was determined by comparing its performance in distinguishing between major depressive disorder cases and non-cases with the Edinburgh Postnatal Depression Scale, which served as the gold standard. Results: On receiver operating characteristic curve analysis, the Patient Health Questionnaire-2 predicted major depressive disorders with 66 percent sensitivity and 89 percent specificity at a cut-off score of 2, with an area under the curve (AUC) of 0.90 [95 percent CI: 0.85-0.94]. For identifying major depressive illness in pregnancy, a cut-off value of 2 was shown to be best for optimizing sensitivity without sacrificing specificity. Women with a PHQ-2 score of 2 had substantially higher Edinburgh Postnatal Depression Scale ratings for depressive symptoms than women with a score less than 2. The PHQ-2 had a positive and negative predictive value of 0.75 and 0.83, respectively. Conclusion: The PHQ-2 is a reliable screening tool for major depression in pregnant women seeking prenatal healthcare in primary care. To confirm the diagnosis, it should be followed by a more comprehensive diagnostic process involving structured clinical interviews or longer diagnostic tools such as the Structured Clinical Interview for DSM Disorders.All authors who submit their paper for publication will abide by following provisions of the copyright transfer: 1. The copyright of the paper rests with the authors. And they are transferring the copyright to publish the article and used the article for indexing and storing for public use with due reference to published matter in the name of concerned authors. 2. The authors reserve all proprietary rights such as patent rights and the right to use all or part of the article in future works of their own such as lectures, press releases, and reviews of textbooks. 3. In the case of republication of the whole, part, or parts thereof, in periodicals or reprint publications by a third party, written permission must be obtained from the Managing Editor of JPRM. 4. The authors declare that the material being presented by them in this paper is their original work, and does not contain or include material taken from other copyrighted sources. Wherever such material has been included, it has been clearly indented or/and identified by quotation marks and due and proper acknowledgements given by citing the source at appropriate places. 5. The paper, the final version of which they submit, is not substantially the same as any that they had already published elsewhere. 6. They declare that they have not sent the paper or any paper substantially the same as the submitted one, for publication anywhere else. 7. Furthermore, the author may only post his/her version provided acknowledgement is given to the original source of publication in this journal and a link is inserted wherever published. 8. All contents, Parts, written matters, publications are under copyright act taken by JPRM. 9. Published articles will be available for use by scholars and researchers. 10. IJPRM is not responsible in any type of claim on publication in our Journal. .