Factor Structure and Differential Item Functioning of the Edinburgh Postnatal Depression Scale: A Comparison of Zulu and English Versions Among Ante- and Postnatal Women Living with HIV in South Africa

Violeta J. Rodriguez, Lissa N. Mandell, Deborah L. Jones

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Measuring perinatal depression in women with HIV poses a challenge to accurate assessment. South Africa has particularly high rates of perinatal depression, with antenatal depression rates ranging from 21 to 47% and postnatal depression rates ranging from 17 to 50%. With the goal of providing an examination of the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) in a population at greater risk for depression, the current manuscript examined the factor structures and reliability of the English and Zulu versions of the EPDS among pre- and postnatal women with HIV in South Africa. Methods: This study included n = 1179 women who completed the EPDS in Zulu (n = 709) and English (n = 470) antenatally, and n = 866 women were analyzed at 12-months after birth (n = 494 in Zulu and n = 372 in English). Results: Using factor analytic and item response theory approaches, the English and Zulu versions of the EPDS were compared. Although a few items performed poorly, particularly item 4, the construct validity of the English and Zulu versions of the pre- and postnatally administered EPDS was supported; the reliability of the scale was also supported, with adequate reliability in Zulu and English ante-natally (α =.78), and postnatally (α =.82 and α =.77 respectively). Discussion: This study contributes to improved measurement of depressive symptoms among vulnerable women in a resource constrained setting. The early and accurate detection of depressive symptoms ante- and postnatally among perinatal women living with HIV can facilitate increased treatment which may in turn help prevent the negative maternal and neonatal outcomes associated with depression.

Original languageEnglish (US)
JournalMaternal and Child Health Journal
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • Edinburgh Postnatal Depression Scale
  • Item response theory
  • Measurement
  • South Africa

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

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