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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2012, Number 1

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Salud Mental 2012; 35 (1)

Detección de depresión en mujeres embarazadas mexicanas con la CES-D

Asunción L, Navarrete L

Language: Spanish
References: 52
Page: 57-62
PDF size: 117.35 Kb.


ABSTRACT

Prenatal depressive symptoms, due to their high prevalence (22% to 37%) and negative consequences on the health of the mother, the baby and the course of pregnancy, require early detection to provide support and treatment. The CES-D is a scale to identify symptoms of depression that is easy and quick to apply and has adequate validity among expectant mothers. The purpose of the study was to analyze the validity and reliability of the CES-D in pregnant Mexican women, as well as its sensitivity, specificity and predictive values using the SCID as the gold standard.
Method The study was based on the secondary analysis of data. A sample of 98 pregnant women attending antenatal care in health center was selected because they displayed depressive symptoms or previous depression.
Results The internal consistency of the CES-D was α=0.81. Factor analysis, which assessed the construct validity, yielded four interpretable factors (depressive affect, lack of energy/somatic symptoms, interpersonal relationships and positive affect), which accounted for 49.10% of the variance. The ROC curve analyses, showed an AUC of 0.81; for a cutoff point of ≥16, showed 100% sensitivity and 19.6% specificity; and sensitivity of 80.0% and specificity of 76.1% for a ≥28 cut-off point.
Conclusions The CES-D showed excellent internal and construct validity in Mexican pregnant women and appeared to be a suitable tool for detecting depressive symptoms −a requisite for implementing preventive actions. However, it was less accurate, but still acceptable, when diagnosing major depression according to DSM-IV criteria with a score of ≥28.


REFERENCES

  1. Breedlov G, Fryzelka D. Depression screening during pregnancy. J Midwifery Women’s Health 2011;56(1):18-25.

  2. Bennett HA, Einarson A, Taddio A, Koren G ET AL. Depression during Pregnancy: Overview of Clinical Factors. Clin Drug Invest 2004;24(3): 157-179.

  3. Ortega L, Lartigue T, Figueroa ME. Prevalencia de depresión, a través de la Escala de Depresión Perinatal de Edimburgo (EPDS). Perinatol Reprod Hum 2001;15(1):11-20.

  4. Lara MA, Navarro C, Navarrete L, Cabrera M et al. Sintomatología depresiva en el embarazo y factores asociados en tres instituciones de salud de la ciudad de México. Salud Ment 2006;29(4):55-62.

  5. Lara MA, Le HN, Letechipia G, Hochhausen L. Prenatal depression in Latinas in the U.S. and Mexico. Matern Child Health J 2009;13(4):567-576.

  6. Chen H, Chan YH, Tan KH, Lee T. Depressive symptomatology in pregnancy. A Singaporean perspective. Soc Psychiatry Psychtr Epidemiol 2004;39(12):975-979.

  7. Goodman SH, Gotlib IH. Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission. Psychol Rev 1999;106(3):458–490.

  8. Bonari L, Bennett H, Einarson A, Koren G. Risks of untreateddepression during pregnancy. Can Fam Physician 2004;50(1):37–39.

  9. Diego MA, Jones NA, Field T, Hernandez-Reif M et al. Maternal psychological distress, prenatal cortisol, and fetal weight. Psychosom Med 2006;68(5):747-753.

  10. Paulson JF, Dauber S, Leiferman JA. Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics 2006;118(2):659-668.

  11. Segre LS, O’Hara MW, Arndt S, Stuart S. The prevalence of postpartum depression: the relative significance of three social status indices. Soc Psychiatry Psychiatr Epidemiol 2007;42(4):316-321.

  12. Radloff LS. The CES-D scale: A self report depression scale for research in the general population. Appl Psychol Measurement 1977;1(3):385-401.

  13. Salgado de Snyder VN, Maldonado M. Características psicométricas de la escala de depresión del Centro de Estudios Epidemiológicos en mujeres mexicanas adultas de áreas rurales. Salud Publica Mex 1994;32(2):200-209.

  14. Tiburcio M, Natera G. Adaptación al contexto ñahñú del Cuestionario de Enfrentamientos (CQ), la Escala de Síntomas (SRT) y la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). Salud Mental 2007;30(3):48-58.

  15. American Psychiatric Association. Manual Diagnóstico y Estadístico de los Trastornos Mentales DSM-IV. Segunda edición. Barcelona, España: Editorial Masson; 2003.

  16. Fechner-Bates S, Coyne JC, Schwenk TL. The relationship of self-reported distress to depressive disorders and other psychopathology. J Consult Clin Psychol 1994;62(3):550-559.

  17. First M, Spitzer R, Gibbon M, Williams J. Structures Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. Washington, DC: American Psychiatric Press; 1996.

  18. Tandon SD, Cluxton-Keller F, Leis J, Le HN. A comparison of three screening tools to identify perinatal depression among low-income African American women. J Affect Disord 2011; Aug 22 doi:10.1016/j.jad.2011. 07.014.

  19. Nguyen HT, Clark M, Ruiz RJ. Effects of acculturation on the reporting of depressive symptoms among Hispanic pregnant women. Nurs Res 2007;56(3):217-223.

  20. Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004b;103(4):698-709.

  21. Lara MA, Navarro C, Navarrete L. Outcome results of a psycho-educational intervention in pregnancy to prevent PPD: a randomized control trial. J Affect Disord 2010;122(1-2):109-117.

  22. Lara MA, Navarro C, Rubí NA, Mondragón L. Outcome of two levels of intervention in low-income women with depressive symptoms. Am J Orthopsychiatry 2003;73(1):35-43.

  23. Vieten C, Astin J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Womens Ment Health 2008;11(1):67-74.

  24. Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetric settings. J Womens Health 2003;12(4):373-380.

  25. Heilemann M, Frutos L, Lee K, Kury FS. Protective strength factors, resources, and risks in relation to depressive symptoms among childbearing women of Mexican descent. Health Care Women Int 2004;25(1):88-106.

  26. Orr ST, Blazer MD, James SA, Reiter JP. Depressive symptoms and indicators of maternal health status during pregnancy, 2007;16(4):535-542.

  27. Breedlov G, Fryzelka D. Depression screening during pregnancy. J Midwifery Women’s Health 2011;56(1):18-25.

  28. Bennett HA, Einarson A, Taddio A, Koren G ET AL. Depression during Pregnancy: Overview of Clinical Factors. Clin Drug Invest 2004;24(3): 157-179.

  29. Ortega L, Lartigue T, Figueroa ME. Prevalencia de depresión, a través de la Escala de Depresión Perinatal de Edimburgo (EPDS). Perinatol Reprod Hum 2001;15(1):11-20.

  30. Lara MA, Navarro C, Navarrete L, Cabrera M et al. Sintomatología depresiva en el embarazo y factores asociados en tres instituciones de salud de la ciudad de México. Salud Ment 2006;29(4):55-62.

  31. Lara MA, Le HN, Letechipia G, Hochhausen L. Prenatal depression in Latinas in the U.S. and Mexico. Matern Child Health J 2009;13(4):567-576.

  32. Chen H, Chan YH, Tan KH, Lee T. Depressive symptomatology in pregnancy. A Singaporean perspective. Soc Psychiatry Psychtr Epidemiol 2004;39(12):975-979.

  33. Goodman SH, Gotlib IH. Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission. Psychol Rev 1999;106(3):458–490.

  34. Bonari L, Bennett H, Einarson A, Koren G. Risks of untreateddepression during pregnancy. Can Fam Physician 2004;50(1):37–39.

  35. Diego MA, Jones NA, Field T, Hernandez-Reif M et al. Maternal psychological distress, prenatal cortisol, and fetal weight. Psychosom Med 2006;68(5):747-753.

  36. Paulson JF, Dauber S, Leiferman JA. Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics 2006;118(2):659-668.

  37. Segre LS, O’Hara MW, Arndt S, Stuart S. The prevalence of postpartum depression: the relative significance of three social status indices. Soc Psychiatry Psychiatr Epidemiol 2007;42(4):316-321.

  38. Radloff LS. The CES-D scale: A self report depression scale for research in the general population. Appl Psychol Measurement 1977;1(3):385-401.

  39. Salgado de Snyder VN, Maldonado M. Características psicométricas de la escala de depresión del Centro de Estudios Epidemiológicos en mujeres mexicanas adultas de áreas rurales. Salud Publica Mex 1994;32(2):200-209.

  40. Tiburcio M, Natera G. Adaptación al contexto ñahñú del Cuestionario de Enfrentamientos (CQ), la Escala de Síntomas (SRT) y la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). Salud Mental 2007;30(3):48-58.

  41. American Psychiatric Association. Manual Diagnóstico y Estadístico de los Trastornos Mentales DSM-IV. Segunda edición. Barcelona, España: Editorial Masson; 2003.

  42. Fechner-Bates S, Coyne JC, Schwenk TL. The relationship of self-reported distress to depressive disorders and other psychopathology. J Consult Clin Psychol 1994;62(3):550-559.

  43. First M, Spitzer R, Gibbon M, Williams J. Structures Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. Washington, DC: American Psychiatric Press; 1996.

  44. Tandon SD, Cluxton-Keller F, Leis J, Le HN. A comparison of three screening tools to identify perinatal depression among low-income African American women. J Affect Disord 2011; Aug 22 doi:10.1016/j.jad.2011. 07.014.

  45. Nguyen HT, Clark M, Ruiz RJ. Effects of acculturation on the reporting of depressive symptoms among Hispanic pregnant women. Nurs Res 2007;56(3):217-223.

  46. Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004b;103(4):698-709.

  47. Lara MA, Navarro C, Navarrete L. Outcome results of a psycho-educational intervention in pregnancy to prevent PPD: a randomized control trial. J Affect Disord 2010;122(1-2):109-117.

  48. Lara MA, Navarro C, Rubí NA, Mondragón L. Outcome of two levels of intervention in low-income women with depressive symptoms. Am J Orthopsychiatry 2003;73(1):35-43.

  49. Vieten C, Astin J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Womens Ment Health 2008;11(1):67-74.

  50. Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetric settings. J Womens Health 2003;12(4):373-380.

  51. Heilemann M, Frutos L, Lee K, Kury FS. Protective strength factors, resources, and risks in relation to depressive symptoms among childbearing women of Mexican descent. Health Care Women Int 2004;25(1):88-106.

  52. Orr ST, Blazer MD, James SA, Reiter JP. Depressive symptoms and indicators of maternal health status during pregnancy, 2007;16(4):535-542.




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