OP57 Validated screening tools for common mental disorders in perinatal women in India: a systematic review and meta-analysis

• Published in: Journal of epidemiology and community health (1979) 2021-09, Vol.75 (Suppl 1), p.A27-A27
• Main Authors: Fellmeth, Gracia, Harrison, Siân, Opondo, Charles, Nair, Manisha, Kurinczuk, Jennifer J, Alderdice, Fiona
• Format: Article
• Language: English
• Subjects: Aggression; Anxiety; Global health; Mental depression; Mental disorders; Meta-analysis; Perinatal care; Postpartum depression; Prenatal depression; Public health; Reviews; Systematic review; Validity
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2021-SSMabstracts.57

BackgroundCommon mental disorders (CMD) in the perinatal period are associated with significant adverse outcomes for women and their families. Prevalence of perinatal CMD is significant in low- and middle-income countries such as India, where women living in socio-economic deprivation, those experiencing intimate partner violence and those with low societal status are at high risk of perinatal mental disorders. Early detection and treatment of perinatal CMD can minimise adverse effects and improve outcomes. However, tools must be validated against a gold-standard locally to assess their psychometric validity and ensure they are culturally appropriate. We aimed to systematically review and synthesise the current evidence on screening tools for perinatal CMD that have been validated in India.MethodsWe searched MEDLINE, Embase, PsycINFO, Global Health, Cochrane Library, Web of Science and Google Scholar without language or date restrictions using search terms for CMD, perinatal status, screening and India. Studies assessing the validity of a screening tool for CMD against a gold standard in women who were pregnant or up to 12 months post-partum in India was included. Two reviewers independently screened titles, abstracts and full-texts and extracted data. Study quality was assessed using the QUADAS-2 tool. We used bivariate and hierarchical summary receiver operating characteristic models to calculate pooled summary estimates of sensitivity and specificity.ResultsWe identified 8306 records of which 2838 were duplicates, 5390 were excluded by title and abstract and 76 were excluded by full-text. Five additional records were identified through grey literature searches. Seven studies were included in the review of which six (1003 participants) were included in meta-analysis. All included studies assessed the validity of the Edinburgh Postnatal Depression Scale (EPDS) in identifying perinatal depression. No studies tested the validity of screening tools for perinatal anxiety. At a threshold of ≥13 the EPDS had a pooled sensitivity of 88·9% (95% CI 77·4–94·9) and pooled specificity of 93·4 (95% CI 81·5–97·8). Two studies had a low risk of bias across all domains; all others had unclear or high risk of bias across at least one domain.ConclusionThe EPDS appears to be psychometrically valid for identifying perinatal depression in India. There is a scarcity of evidence around the validity of other screening tools for perinatal CMD in India, with no studies of screenin