Postnatal depressive symptoms display marked similarities across continents

Rikke Wesselhoeft; Frederikke Kjerulff Madsen; Mia Beck Lichtenstein; Christian Sibbersen; Rachel Manongi; Declare L. Mushi; null Hanh Thi Thuy Nguyen; null Toan Ngo Van; Henriette Kyhl; Niels Bilenberg; Dan W. Meyrowitsch; Tine M. Gammeltoft; Vibeke Rasch

doi:10.1016/j.jad.2019.09.075

Postnatal depressive symptoms display marked similarities across continents

Rikke Wesselhoeft, Frederikke Kjerulff Madsen, Mia Beck Lichtenstein, Christian Sibbersen, Rachel Manongi, Declare L. Mushi, Hanh Thi Thuy Nguyen, Toan Ngo Van, Henriette Kyhl, Niels Bilenberg, Dan W. Meyrowitsch, Tine M. Gammeltoft, Vibeke Rasch

Global Health Section

4 Citations (Scopus)

Abstract

Background: Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. Methods: A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were self-reported 40–90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. Results: A total of N = 4,516 participated in the study (Denmark N = 2,069, Vietnam N = 1,278, Tanzania N = 1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item ‘self-harm’ loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cut-off 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). Limitations: EPDS data was collected at a later time point in the Danish sample. Conclusions: Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.

Original language	English
Journal	Journal of Affective Disorders
Volume	261
Pages (from-to)	58-66
ISSN	0165-0327
DOIs	https://doi.org/10.1016/j.jad.2019.09.075
Publication status	Published - 15 Jan 2020

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10.1016/j.jad.2019.09.075

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Wesselhoeft, R., Madsen, F. K., Lichtenstein, M. B., Sibbersen, C., Manongi, R., Mushi, D. L., Hanh Thi Thuy Nguyen, Toan Ngo Van, Kyhl, H., Bilenberg, N., Meyrowitsch, D. W., Gammeltoft, T. M., & Rasch, V. (2020). Postnatal depressive symptoms display marked similarities across continents. Journal of Affective Disorders, 261, 58-66. https://doi.org/10.1016/j.jad.2019.09.075

@article{bee5d290c0b14f52936a99a41d1ec29c,

title = "Postnatal depressive symptoms display marked similarities across continents",

abstract = "Background: Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. Methods: A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were self-reported 40–90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. Results: A total of N = 4,516 participated in the study (Denmark N = 2,069, Vietnam N = 1,278, Tanzania N = 1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item {\textquoteleft}self-harm{\textquoteright} loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cut-off 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). Limitations: EPDS data was collected at a later time point in the Danish sample. Conclusions: Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.",

author = "Rikke Wesselhoeft and Madsen, {Frederikke Kjerulff} and Lichtenstein, {Mia Beck} and Christian Sibbersen and Rachel Manongi and Mushi, {Declare L.} and {Hanh Thi Thuy Nguyen} and {Toan Ngo Van} and Henriette Kyhl and Niels Bilenberg and Meyrowitsch, {Dan W.} and Gammeltoft, {Tine M.} and Vibeke Rasch",

year = "2020",

month = jan,

day = "15",

doi = "10.1016/j.jad.2019.09.075",

language = "English",

volume = "261",

pages = "58--66",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier",

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TY - JOUR

T1 - Postnatal depressive symptoms display marked similarities across continents

AU - Wesselhoeft, Rikke

AU - Madsen, Frederikke Kjerulff

AU - Lichtenstein, Mia Beck

AU - Sibbersen, Christian

AU - Manongi, Rachel

AU - Mushi, Declare L.

AU - Hanh Thi Thuy Nguyen, null

AU - Toan Ngo Van, null

AU - Kyhl, Henriette

AU - Bilenberg, Niels

AU - Meyrowitsch, Dan W.

AU - Gammeltoft, Tine M.

AU - Rasch, Vibeke

PY - 2020/1/15

Y1 - 2020/1/15

N2 - Background: Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. Methods: A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were self-reported 40–90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. Results: A total of N = 4,516 participated in the study (Denmark N = 2,069, Vietnam N = 1,278, Tanzania N = 1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item ‘self-harm’ loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cut-off 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). Limitations: EPDS data was collected at a later time point in the Danish sample. Conclusions: Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.

AB - Background: Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. Methods: A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were self-reported 40–90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. Results: A total of N = 4,516 participated in the study (Denmark N = 2,069, Vietnam N = 1,278, Tanzania N = 1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item ‘self-harm’ loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cut-off 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). Limitations: EPDS data was collected at a later time point in the Danish sample. Conclusions: Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.

U2 - 10.1016/j.jad.2019.09.075

DO - 10.1016/j.jad.2019.09.075

M3 - Journal article

C2 - 31600588

SN - 0165-0327

VL - 261

SP - 58

EP - 66

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Postnatal depressive symptoms display marked similarities across continents

Abstract

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