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Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru

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Abstract

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen’s kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.

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Acknowledgments

This research was supported by an award from the National Institutes of Health (NIH), the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru, and Instituto Especializado Materno Perinatal, Peru, for their expert technical assistance with this research. The authors would like to thank Kathy Brenner for her help with revising this manuscript.

Conflict of interest

No potential conflicts of interest were disclosed.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA

    Qiu-Yue Zhong, Bizu Gelaye, David C. Henderson, Yasmin V. Barrios & Michelle A. Williams

  2. Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru

    Marta B. Rondon

  3. Universidad Peruana de Ciencias Aplicadas, Lima, Peru

    Sixto E. Sánchez

  4. Asociación Civil PROESA, Lima, Peru

    Sixto E. Sánchez

  5. Group Health Research Institute, Seattle, WA, USA

    Gregory E. Simon

  6. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    David C. Henderson

  7. Harvard Medical School, Boston, MA, USA

    David C. Henderson

  8. Universidad Nacional Mayor de San Marcos, Lima, Peru

    Pedro Mascaro Sánchez

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  1. Qiu-Yue Zhong
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Correspondence to Qiu-Yue Zhong.

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Zhong, QY., Gelaye, B., Rondon, M.B. et al. Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Arch Womens Ment Health 18, 783–792 (2015). https://doi.org/10.1007/s00737-014-0481-0

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  • DOI: https://doi.org/10.1007/s00737-014-0481-0

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