A comparison of three screening tools to identify perinatal depression among low-income African American women

S. Darius Tandon*, Fallon Cluxton-Keller, Julie Leis, Huynh Nhu Le, Deborah F. Perry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

111 Scopus citations


Background: The purpose of the current study was to determine the sensitivity, specificity, and positive predictive value of three depression screening tools among a low-income African American population of pregnant and recently delivered women enrolled in home visitation programs in a low-income urban community. Methods: Ninety-five women enrolled in home visitation programs-32 who were pregnant and 63 with a child < 6 months comprise the study sample. Each woman completed a structured clinical interview and three depression screening tools-the Edinburgh Postnatal Depression Scale (EPDS), Center for Epidemiologic Studies Depression Scale (CES-D), and Beck Depression Inventory II (BDI-II). Results: Over a quarter of women (28.4%) were experiencing major depression. Each screening tool was highly accurate in detecting major depression and major or minor depression among prenatal and postpartum women, with areas under the curve (AUCs) > 0.90. Sensitivities of all screening tools were improved when using cutoffs lower than those considered standard by instrument developers. Limitations: Participants were recruited from home visitation programs in an urban context which may limit generalizability to other populations of low-income African American women. Given that no women during pregnancy met criteria for minor depression, it was not possible to determine optimal prenatal cutoff scores. Conclusions: Three depression screening tools-the EPDS, CES-D, and BDI-II-appear to be reliable and brief assessments of major and minor depression among low-income African American perinatal women. Providers using these tools should consider using lower cutoff scores to most effectively identify women in need of depression treatment.

Original languageEnglish (US)
Pages (from-to)155-162
Number of pages8
JournalJournal of Affective Disorders
Issue number1-2
StatePublished - Jan 2012


  • African American
  • Home visiting
  • Postpartum depression
  • Screening

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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