Concordance of the Thai versions of the Patient Health Questionnaire and Edinburgh Post-natal Depression Scale for Antenatal Depression

Abstract

Objective: To compare the Thai versions of the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) and examine the associated factors with the degree of concordance for assessing depression in pregnant Thai women. Material and Methods: This was a cross-sectional study conducted in November-December 2022. The Thai versions of both the PHQ-9 and EPDS were completed by pregnant women at the Antenatal Care Clinic, Songklanagarind Hospital, Thailand. Descriptive data analysis and multivariate logistic regression were performed using The R Program to categorize “normal” and “increased risk of antenatal depression” and examine the statistical agreement, associated factors, and concordance between the two tools. Results: Of the 135 pregnant Thai women enrolled in the study, most lived in non-restive areas of southern Thailand (80.7%) with a mean age of 31.7 years. Most participants were found “normal” for antenatal depression screening by the Thai versions of both the PHQ-9 and the EPDS (89.6% and 88.9%, respectively). Complete concordance between the PHQ-9 and EPDS tests was found in 122 of the women, with 84.4% of all women found ‘normal’ and 5.9% found to have “increased risk of antenatal depression” with both questionnaires. The overall agreement between the 2 questionnaires was statistically significant (Kappa=0.4979, p-value<0.0001, Z=5.79). The statistical analysis identified no demographic factors associated with the concordance. Conclusion: The Thai versions of the PHQ-9 and the EPDS for antenatal depression screening had significantly moderate agreement. The statistical analysis found no factors associated with the concordance.