Abstract
The aims of this study were to identify the frequency of the risk factors for postpartum depression (PPD) listed in the Postpartum Depression Predictors Inventory-Revised (PDPI-R) during pregnancy and 1 month after delivery and to determine the predictive validity of the PDPI-R. The study used a prospective cohort design. Women completed the PDPI-R at the 3rd and the 8th months of pregnancy and at the 1st month after childbirth. Women were prospectively followed across three different time points during the postpartum using Structured Clinical Interview for DSM-IV Disorders to determine the presence of major or minor depression. The prenatal version of the PDPI-R administered at two different time points during pregnancy predicted accurately 72.6% and 78.2% of PPD and the full version administered at the 1st month after delivery predicted 83.4% of PPD. The cutoffs identified were 3.5 for the prenatal version and 5.5 for the full version. The PDPI-R is a useful and a valid screening tool for PPD.
Similar content being viewed by others
References
Appleby L, Gregoire A, Platz C et al (1994) Screening women for high risk of postnatal depression. J Psychosom Res 38:539–545
Austin MP, Hadzi-Pavlovic D, Saint K et al (2005) Antenatal screening for the prediction of postnatal depression: validation of a psychosocial pregnancy risk questionnaire. Acta Psychiatr Scand 112:310–317
Beck CT (1996a) A meta-analysis of predictors of postpartum depression. Nurs Res 45:297–303
Beck CT (1996b) A meta-analysis of the relationship between postpartum depression and infant temperament. Nurs Res 45:225–230
Beck CT (2001) Predictors of postpartum depression: an update. Nurs Res 50:275–285
Beck CT (2002) Revision of the postpartum depression predictors inventory. J Obstet Gynecol Neonatal Nurs 31(4):394–402
Beck CT, Records K, Rice M (2006) Further development of the Postpartum Depression Predictors Inventory-Revised. J Obstet Gynecol Neonatal Nurs 35(6):735–745
Bennett HA, Einarson A, Taddio A et al (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103(4):698–709
Bernazzani O, Marks MN, Bifulco A et al (2005) Assessing psychosocial risk in pregnant/postpartum women using the contextual assessment of maternity experience (CAME). Soc Psychiatry Psychiatr Epidemiol 40:497–508
Borri C, Mauri M, Oppo A et al (2008) Axis-I psychopathology and functional impairment at the 3rd month of pregnancy. Results from the Perinatal Depression-Research & Screening Unit (PND-ReScU) Study. J Clin Psychiatry 69(10):1617–1624
Boyce P, Hickey A, Gilchrist J et al (2001) The development of a brief personality scale to measure vulnerability to postnatal depression. Arch Women Ment Health 3:147–153
Boyer D, Van Der Leden M, Bacom C (1990) Prediction of postpartum depressive symptoms in low income Black women. Unpublished manuscript
Braverman J, Roux J (1978) Screening for the patient at risk for postpartum depression. Obstet Gynecol 52:731–736
Buist AE, Barnett BEW, Milgrom J et al (2002) To screen or not to screen—that is the question in perinatal depression. Med J Aust 177:101–105
Committee on Drugs (2000) Use of psychoactive medication during pregnancy and possible effects on the fetus and newborn. Pediatrics 105:880–887. doi:10.1542/peds.1054.880
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786
Cox JL, Murray D, Chapman GA (1993) Controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry 163:27–31
Eberhard-Gran M, Eskild A, Tambs K et al (2001) Review of validation studies of the Edinburgh postnatal depression scale. Acta Psychiatr Scand 104:243–249
First MB, Spitzer RL, Gibbon M et al (1995) Structured clinical interview for DSM-IV axis I disorders (SCID). New York State Psychiatric Institute, Biometrics Research, New York
Fletcher RH, Fletcher SW, Wagner EH (1996) Clinical epidemiology: the essentials. Williams & Wilkins, Baltimore
Food and Drug Admistration (1979) Labeling and prescription drug advertising: content and format for labelling for human prescription drugs. Fed Regist 44:37434–37467
Gaynes, BN, Gavin, N, Meltzer-Brody S et al (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment No. 119. (Prepared by the RTI-University of North Carolina Evidence-based Practice Center, under Contract No. 290-02-0016.) AHRQ Publication No. 05-E006-2. Rockville, MD: Agency for Healthcare Research and Quality
Glangeaud-Freudenthal NMC, Boyce P (2003) Postpartum depression: risk-factors and treatments—introduction. Arch Women Ment Health 6(2):s31–s32
Hanna B, Jarman H, Savage S et al (2004) The early detection of postpartum depression: midwives and nurses trial a checklist. J Obstet Gynecol Neonatal Nurs 33(2):191–7
Kim HG, Mandell M, Crandall C et al (2006) Antenatal psychiatric illness and adequacy of prenatal care in an ethnically diverse inner-city obstetric population. Arch Women Ment Health 9(2):103–7
Kitamura T, Shima S, Sugaware M et al (1993) Psychological and social correlates of the onset of affective disorder among pregnant women. Psychol Med 23:967–975
Marcus SM, Flynn HA, Blow FC et al (2003) Depressive symptoms among pregnant women screened in obstetric settings. J Women Health 12:373–380
Matthey S, Henshaw C, Elliott S et al (2006) Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale—implications for clinical and research practice. Arch Women Ment Health 9:309–315
Milgrom J, Ericksen J, Negri L et al (2005) Screening for postnatal depression in routine primary care: properties of the Edinburgh postnatal depression scale in an Australian sample. Aust N Z J Psychiatry 39(9):833–839
Milgrom J, Gemmill AW, Bilszta JL et al (2008) Antenatal risk factors for postnatal depression. A large prospective study. J Affect Disord 108:147–157
O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 8:37–54
O’Hara MW, Schlechte JA, Lewis DA et al (1991) Controlled prospective study of postpartum mood disorders: psychological, environmental and hormonal variables. J Abnorm Psychol 100(1):63–73
Petrick J (1984) Postpartum depression: identification of high risk mothers. J Obstet Gynecol Neonat Nurs 13:37–40
Posner NA, Unterman RR, Williams KN et al (1997) Screening for postpartum depression: an antepartum questionnaire. J Reprod Med 42:207–215
Priest SR, Austin MP, Barnett B, Buist A (2008) A psychosocial risk assessment model (PRAM) for use with pregnant and postpartum women in primary care settings. Arch Women Ment Health . doi:10.1007/s00737-008-0028-3
Records K, Rice M, Beck CT (2007) Psychometric assessment of the Postpartum Depression Predictors Inventory-Revised. J Nurs Meas 15(3):189–201
Reid AJ, Biringer A, Carroll JC et al (1998) Using the ALPHA form in practice to assess antenatal psychosocial health. CMAJ 159:677–684
Robertson E, Sherry G, Wallington T et al (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295
Ross LE, Campbell VLS, Dennis CL et al (2006) Demographic characteristics of participants in studies of risk factors, prevention, and treatment of postpartum depression. Can J Psychiatry 51:704–710
Ryan D, Milis L, Misri N (2005) Depression during pregnancy. Can Fam Physician 51:1087–1093
Shakespeare J (2002) Evaluation of screening for postnatal depression against the NSC handbook criteria. Prepared for a working party, June 2001. <http://www.nelh.nhs.uk/screening/adult_pps/ postnatal_depression.html>. Accessed Jan 2002, Jul 2002.
Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 35:773–782
Stamp G, Williams A, Crowther C (1996) Predicting postnatal depression among pregnant women. Birth 23:218–223
Swets JA, Picket RM (1982) Evaluation of diagnostic systems. Academic, New York
Swets JA (1992) The science of choosing the right decision threshold in high-stakes diagnostics. Am Psychol 47:522–532
Webster J, Pritchard MA, Creedy D et al (2003) A simplified predictive index for the detection of women at risk for postnatal depression. Birth 30:101–108
Acknowledgement
This research was funded with a grant from the Italian Ministry of Health and liberal grants from IDEA and Stella Major Foundations (no-profit advocacy associations) and Pfizer Italia. The PND-ReScU staff includes Drs. Banti S., Borri C., Rambelli C., Ramacciotti D., Montagnani M., Camilleri V., Cortopassi S., Bettini A., Ricciardulli S., Luisi S., Bruni J., Cianelli E., Mazzoni R., Corradini A., Cirri C., Di Biase S., Montaresi S., Casimo L., Giunti Y., Ciaponi B., and Oppo A. The authors thank Giulia Gray for editing the final version of the paper. We thank all the women who participated without whom this study would not have been possible.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Oppo, A., Mauri, M., Ramacciotti, D. et al. Risk factors for postpartum depression: the role of the Postpartum Depression Predictors Inventory-Revised (PDPI-R). Arch Womens Ment Health 12, 239–249 (2009). https://doi.org/10.1007/s00737-009-0071-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-009-0071-8