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Fulltext Validation of the Malay version of Edinburgh Postnatal Depression Scale for postnatal women in Kelantan, Malaysia

Abdul Kadir A, Nordin R, Ismail SB, Yaacob MJ, Wan Mustapha WMR

Asia Pac Fam Med, 2004;3(1&2):9-18.

Aim. Validation of the Malay version of the Edinburgh Postnatal Depression Scale (EPDS)
Methods. A validation study was done involving 52 mothers who were at 4-12 weeks post-delivery. The women completed the Malay versions of EPDS and the 30-item General Health Questionnaire (GHQ). They were then assessed with the Hamilton Depression Rating Scale (HDRS) and Clinical Interview Schedule (CIS). Psychiatric diagnoses were made based on ICD-10 criteria. The validity of EPDS was tested against this clinical diagnosis and the concurrent validity against the Malay version of 30-item GHQ and HDRS scores was also evaluated.
Results. The best cut-off score of the Malay version of EPDS was 11.5 with the sensitivity of 72.7% and specificity of 92.6 %.
Conclusion. The Malay version of EPDS is a valid and reliable screening tool for PND.

Matched MeSH terms: Depression, Postpartum
The relationship between post-natal depression, somatization and behaviour in Malaysian women

Grace J, Lee KK, Ballard C, Herbert M

Transcult Psychiatry, 2001;38:27-34.
DOI: 10.1177/136346150103800103

This study evaluated the rate of post-natal depression (PND) in a Malaysian population, investigated the relationship between belief systems and PND, and examined the relationship between PND and somatization. The sample included 154 consecutive attendees for a 6-week post-natal check at a general hospital well-baby clinic in Kuala Lumpur. Patients were assessed using the Edinburgh Post-Natal Depression Score (EPNDS), the Bradford Somatisation Inventory (BSI), and a questionnaire to assess beliefs about pregnancy and childbirth. The rate of PND was 3.9%. EPNDS and BSI were moderately correlated. Women who practised specific post-natal practices had a higher EPNDS and BSI than those who did not. The rate of PND is lower than in Western studies but similar to that seen in other Asian countries. The correlation between BSI and EPNDS suggest that the BSI will not detect cases missed by the EPNDS. © 2001, Sage Publications. All rights reserved.

Matched MeSH terms: Depression, Postpartum
Fulltext The influence of parenting stress on postpartum depression among newly delivered women. [Pengaruh tekanan keibubapaan terhadap kemurungan postpartum dalam kalangan wanita baru bersalin.]

Abdul Latiff R, Wan Sulaiman WS, Hoesni S

Jurnal Psikologi Dan Pembangunan Manusia, 2013;1(1):12-21.

Postpartum depression is one of the major depressions experienced by women during three months after giving birth to their babies. The symptoms of this type of depression cannot be taken lightly as it affects not only the women but also the development of the babies, family harmony and functioning and can in fact harm themselves and other individuals in their surrounding. Thus, this research was conducted to identify the influence of parental stress towards postpartum depression. A total of 181 women participated in this study and they were from two groups namely married and unmarried women who just gave birth. Two instruments were used and they were the Postpartum Depression Screening Scale and the Parental Stress Index Short Form. Results obtained showed that parental stress and its dimensions were significantly correlated with postpartum depression. In addition, maternal stress and difficult child characteristics were significant predictors of postpartum depression. Findings also showed that there were significant differences of parental stress and its dimensions between married and unmarried women who just gave birth. These findings imply the importance of coping with parental stress to prevent women from experiencing postpartum depression.
Keywords Postpartum Depression · Parental Stress · Child Characteristics · Regression

Matched MeSH terms: Depression, Postpartum
Fulltext The influence of hospital practices and family support on breastfeeding duration, adverse events, and postnatal depression among first-time mothers

Sarah Dib, Jonathan CK Wells, Nurul Husna M Shukri

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):90-98.
MyJurnal

Introduction: Baby-friendly hospital practices and family support are recognised to improve the chances of success- ful breastfeeding. The associations between support and maternal psychological state and breastfeeding problems are less explored. This study aimed to assess the influence of professional and family support on breastfeeding ad- verse events and postpartum depression at 2 weeks and exclusive breastfeeding (EBF) status at 12 weeks postpartum, and to identify predictors of positive outcomes. Methods: 64 primiparous Malaysian mothers were interviewed face-to-face, at 2, 6 and 12 weeks post-delivery, to collect data regarding family support, hospital and infant feeding practices, breastfeeding problems and pain, maternal perceptions and depression. Logistic regression and correlation were used to ascertain associations between support and EBF, adverse events and postpartum depression. Results: Neither professional nor family support predicted EBF at 12 weeks. Eighty-five percent of the mothers received high family support, which was associated with lower depression scores (r=-0.36, p=0.005); higher depression scores were associated with more breastfeeding problems. EBF discontinuation before 12 weeks was predicted by maternal perception of insufficient milk supply (OR=8.96, CI=1.78, 45.18). Earlier breastfeeding initiation (r=0.26, p=0.04) and skin-to-skin contact (r=0.25, p=0.048) were associated with lower breastfeeding pain. EBF in hospital was cor- related with fewer breastfeeding problems (r=0.31, p=0.01). Conclusion: Mothers with greater family support suf- fered from less depressive symptoms, which could lower the incidence of breastfeeding problems and prolong EBF duration. Skin-to-skin contact, early breastfeeding initiation and EBF in hospital were associated with less adverse events, thus better compliance with these Baby-Friendly practices is recommended.

Matched MeSH terms: Depression, Postpartum
Fulltext The Malaysian Women's Experience of Care and Management of Postnatal Depression

Arifin SRBM, Cheyne H, Maxwell M, Yousuf A

Clin Pract Epidemiol Ment Health, 2021;17:10-18.
PMID: 34040649 DOI: 10.2174/1745017902117010010

Objectives: Early detection and intervention for Maternal Postnatal Depression (PND) are imperative to prevent devastating consequences for mothers, babies, and families. However, there are no guidelines that explicitly focus on the management of PND in Malaysia. Consequently, it is unclear whether women with PND are receiving proper care and treatment. Therefore, this study aimed to explore Malaysian Women's experience in managing PND symptoms.
Methods: A qualitative study was conducted among 33 women attending Maternal and Child Health (MCH) clinics in Kuala Lumpur. Data were obtained through a face-to-face semi-structured interview and analysed using framework analysis.
Results: The women considered PND as a personal and temporary issue. Therefore, professional care was deemed unnecessary for them. Additionally, all Malay women considered religious approach as their primary coping strategy for PND. However, this was not the case for most Indian and Chinese women.
Conclusion: The findings of this study indicated that women did not acknowledge the roles of Healthcare Practitioners (HCPs) in alleviating their emotional distress.Also, they perceived PND as a personal problem and less serious emotional condition. It is due to this perception that the women adopted self-help care as their primary coping strategy for PND. However, the coping strategy varied between different cultures. These findings underscore the importance of HCPs' proactive action to detect and alleviate PND symptoms as their attitude towards PND may influence Women's help-seeking behaviour.

Matched MeSH terms: Depression, Postpartum
The Effectiveness of Hypnosis Intervention in Alleviating Postpartum Psychological Symptoms

Beevi Z, Low WY, Hassan J

Am J Clin Hypn, 2019 Apr;61(4):409-425.
PMID: 31017553 DOI: 10.1080/00029157.2018.1538870

Psychological symptoms, particularly postpartum depression, may impair women's well-being after childbirth. Mind-body treatments such as hypnosis are available to help prepare women to maintain or improve their well-being postpartum. The aims of the present study are to determine the effectiveness of a hypnosis intervention in alleviating psychological symptoms (stress, anxiety, and depression) and the symptoms of postpartum depression. A quasi-experimental design was utilized in this study. The experimental group participants (n = 28) received a hypnosis intervention at weeks 16, 20, 28, and 36 of their pregnancies. Participants in the control group (n = 28) received routine prenatal care. The final data collection, occurring at two months postpartum, included 16 women from the experimental group and 11 women from the control group. The Depression Anxiety Stress Scale-21 (DASS-21) was used to measure psychological symptoms, and postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The results at two months postpartum showed that the experimental group had significantly lower postpartum anxiety than the control group (M = 2.88 versus M = 38.36, p = .023). Similarly, the experimental group had significantly lower postpartum depressive symptoms than the control group (M = 1.25 versus M = 6.73, p postpartum stress symptoms were not significant (p = .363). Finally, the results indicated that the experimental group experienced reduced postpartum depression when compared to the control group (M = 5.69 versus M = 10.64, p postpartum.

Matched MeSH terms: Depression, Postpartum/prevention & control
Fulltext The Association Between Demographic Characteristics and Attempting of Pregnancy with Postpartum Depression and Anxiety Among Women Referring to Community Health Centres: A Cross Sectional Study

Alikamali M, Khodabandeh S, Motesaddi M, Bagheri Z, Esmaeili MA

Malays J Med Sci, 2020 May;27(3):93-104.
PMID: 32684810 DOI: 10.21315/mjms2020.27.3.10

Background: Postpartum depression (PPD) and anxiety are considered as a risk factor for mother and infant health. Therefore, the present study aims to explore the association between demographic characteristics and pregnancies with PPD and anxiety.
Methods: A cross-sectional study was conducted on 400 Iranian women referring to health centres of the Zarand City four weeks to six months from the date of their childbirth, in the first half of 2018.
Result: The results showed that employed women with pregnancies who were categorised as depression and anxiety were more likely to have low gestational age, food insecurity, several deliveries, cesarean delivery and unintended pregnancy as well as they were not satisfied with their infant's gender. Also, women with several deliveries had lower risk for PPD before and after adjustment for confounders (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.88-0.97, P < 0.001) and had lower risk for postpartum anxiety only after adjustment for confounders (OR = 0.82, 95% CI: 0.75-0.89, P < 0.001).
Conclusion: Eventually, demographic characteristics and attempting of pregnancy were independently associated with PPD and postpartum anxiety in women. There need to be more social and governmental support of employed women after delivery to decrease their occupational stresses to deal with PPD and anxiety in the studied population.

Matched MeSH terms: Depression, Postpartum
State of the science on postpartum depression: what nurse researchers have contributed-part 2

Beck CT

MCN Am J Matern Child Nurs, 2008 Mar-Jun;33(3):151-6; quiz 157-8.
PMID: 18453904 DOI: 10.1097/01.NMC.0000318349.70364.1c

This two-part series summarizes 141 postpartum depression studies that have been conducted by nurse researchers from around the globe. Studies contributing to the knowledge base of postpartum depression were conducted in the following nine countries: United States, Australia, Canada, China (Hong Kong, Taiwan), Finland, Iceland, Sweden, Turkey, and Malaysia. Part 1 of this series addressed the contributions of nurse researchers in the areas of epidemiology, risk factors, and transcultural perspectives related to postpartum depression. This article is Part 2, and it describes what nurse researchers have contributed to the following aspects of postpartum depression: instrumentation/screening, interventions, mother-infant interactions, family dynamics, breastfeeding, preterm births, biological factors, clinicians' knowledge, and mothers' use of health services.

Matched MeSH terms: Depression, Postpartum/diagnosis; Depression, Postpartum/nursing*; Depression, Postpartum/psychology
State of the Science on postpartum depression: what nurse researchers have contributed--part 1

Beck CT

MCN Am J Matern Child Nurs, 2008 Mar-Apr;33(2):121-6.
PMID: 18327112 DOI: 10.1097/01.NMC.0000313421.97236.cf

Postpartum depression has been described as a thief that steals motherhood. It can result in tragedy and sometimes in headline-gripping maternal suicide or infanticide. Because one of the highest priorities for nursing is to continually advance the knowledge that underlies nursing practice, it is essential that we understand what nurse researchers have done to advance the knowledge base of postpartum depression. This integrative review is a two-part series for MCN that summarizes 141 postpartum depression studies conducted by nurse researchers from around the globe, including United States, Australia, Canada, China (Hong Kong, Taiwan), Finland, Iceland, Sweden, Turkey, and Malaysia. Specific areas of postpartum depression to which nurse researchers have devoted their primary attention include epidemiology, risk factors, transcultural perspectives, instrument development, screening, interventions, and mother-infant interactions.

Matched MeSH terms: Depression, Postpartum/ethnology; Depression, Postpartum/nursing; Depression, Postpartum/prevention & control*; Depression, Postpartum/psychology
Stability of depressive symptoms over 3 months post-partum

Abdollahi F, Zarghami M, Sazlina SG, Lye MS

Early intervention in psychiatry, 2017 Feb;11(1):57-62.
PMID: 25582677 DOI: 10.1111/eip.12215

AIM: Prolonged depression during the post-partum period is associated with maternal and infant mortality and morbidity. Less attention has been given to factors that predict the persistence of depression beyond the first 3 months post-partum.
METHODS: From a longitudinal cohort of 2279 women who attended Mazandaran's primary health centres in 2009, 478 women with an Edinburgh Postnatal Depression Scale (EPDS) score of 12 or greater in the third trimester of pregnancy were recruited. Persistently depressed women (depressed at all three occasions: during pregnancy, and at 2 and 12 weeks post-partum) were compared with those without depression to determine demographic, cultural, obstetric and biopsychosocial predictors for persistence of depression. Data were analysed using chi-square test, t-test and logistic regression models.
RESULTS: The stability of depression was found in 193 (46.2 %) of 418 depressed cases who were followed up over the study period. Of those mothers who scored more than the threshold of 12 during the third trimester of pregnancy, 277 (66.3%) and 221 (52.9%) had high EPDS at 2 and 12 weeks post-partum. Psychological distress (based upon the General Health Questionnaire), low maternal parental self-efficacy (based upon the Parental Expectation Survey) and perceived social isolation (based upon the Network Orientation Scale) were independent predictors of persistent depression.
CONCLUSION: Fewer depressed mothers in this study were found to recover during the first 3 months after giving birth. Psychosocial factors predicted sustained depression from pregnancy to 3 months post-partum. The findings highlight the significance of support in enhancing maternal mental health.

Matched MeSH terms: Depression, Postpartum/diagnosis*; Depression, Postpartum/epidemiology; Depression, Postpartum/psychology*
Severe Maternal Morbidity and Postpartum Depressive Symptomatology: A Prospective Double Cohort Comparison Study

Norhayati MN, Nik Hazlina NH, Aniza AA, Asrenee AR

Res Nurs Health, 2016 Dec;39(6):415-425.
PMID: 27367484 DOI: 10.1002/nur.21741

The adverse consequences to mothers of postpartum depression are well-documented, and risk factors are of interest. There is limited evidence on postpartum depression among women with severe maternal morbidity, defined as potentially life-threatening conditions during pregnancy, childbirth, or soon after termination of pregnancy. We compared postpartum depressive symptoms of postpartum women aged 18 and older who delivered in two tertiary referral hospitals in 2014 in Kelantan, Malaysia, and had (n = 145) or had not (n = 187) suffered severe maternal morbidity. A prospective double cohort study design was applied. Postpartum depressive symptoms were assessed at 1 and 6 months postpartum using the Malay version of the Edinburgh Postnatal Depression Scale. There was no significant difference in the mean Edinburgh Postnatal Depression Scale score changes (p = .803) between the two groups of women, after adjusting for age, social support, physical health, occupation, and education. Factors other than severe medical complications should be pursued as predictors of postpartum depressive symptomatology. © 2016 Wiley Periodicals, Inc.

Matched MeSH terms: Depression, Postpartum/epidemiology*
Fulltext Role of the husband's knowledge and behaviour in postnatal depression: a case study of an immigrant Pakistani woman

Khan TM, Arif NH, Tahir H, Anwar M

Ment Health Fam Med, 2009 Dec;6(4):195-201.
PMID: 22477910

Objective. This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.
Methods. A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.
Results. The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.
Conclusion. This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.

Matched MeSH terms: Depression, Postpartum
Risk of postnatal depression after emergency delivery

Koo V, Lynch J, Cooper S

J Obstet Gynaecol Res, 2003 Aug;29(4):246-50.
PMID: 12959147

AIM: To identify whether women having emergency delivery are at increased risk of developing postnatal depression (PND).
METHODS: This is a retrospective comparative cohort study design. Two hundred and fifty Malaysian women were part of a previous study examining the prevalence of PND in a multiracial country and the effects of postnatal rituals. All women were at least 6 weeks post-partum when asked to complete the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic and birth data were obtained.
RESULTS: Data collected were divided into two groups: 55 emergency delivery and 191 non-emergency delivery. There were four missing data. There was no significant difference in the mean age, parity, gestational period, baby birthweight, 5 min baby Apgar score and EPDS scores of the two groups. However, the analysis of PND indicated that women with emergency delivery had a relative risk of 1.81 compared with women with non-emergency delivery. The comparison of the two groups using chi2 indicated a significant (chi2 = 3.94, d.f. = 1, P = 0.04) increase in the presence of PND in the emergency delivery.
CONCLUSION: When compared with women having non-emergency delivery, women having emergency delivery had about twice the risk of developing PND. Special attention to this group appears warranted.

Matched MeSH terms: Depression, Postpartum/etiology; Depression, Postpartum/epidemiology*
Fulltext Review of the prevalence of postnatal depression across cultures

Arifin SRM, Cheyne H, Maxwell M

AIMS Public Health, 2018;5(3):260-295.
PMID: 30280116 DOI: 10.3934/publichealth.2018.3.260

The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8-27.3%. This review indicated that the widely cited prevalence of maternal PND of 10-15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.

Matched MeSH terms: Depression, Postpartum
Fulltext Revalidation of the Malay Version of the Edinburgh Postnatal Depression Scale (EPDS) Among Malay Postpartum Women Attending the Bakar Bata Health Center in Alor Setar, Kedah, North West Of Peninsular Malaysia

Mahmud WM, Awang A, Mohamed MN

Malays J Med Sci, 2003 Jul;10(2):71-5.
PMID: 23386800

AIM: To reevaluate the psychometric characteristics of the Malay version of the Edinburgh Postnatal Depression Scale among a sample of postpartum Malay women attending the Bakar Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia.
MATERIALS AND METHODS: 64 women between 4 to 12 weeks postpartum were recruited for there validation study. They were given questionnaires on socio-demography, the 21-item Malay version of the Beck Depression Inventory II (BDI-II) and the 10-item Malay version of the Edinburgh Postnatal Depression Scale (EPDS). All the participants were later interviewed using the Hamilton Depression Rating Scale (HDRS-17) and the Composite International Diagnostic Interview (CIDI). All diagnoses were made based on the Tenth Edition of the International Classification of Diseases (ICD-10)
RESULTS: 9 women (14.1%) were diagnosed to have significant depression (7 mild depressive episodes and 2 moderate depressive episodes according to ICD-10). EPDS was found to have good internal consistency (Cronbach alpha =0.86) and split half reliability (Spearman split half coefficient = 0.83). The instrument also showed satisfactory discriminant and concurrent validity as evidenced by the statistically significant difference in EPDS scores between the depressed group and their non-depressed counterparts (Mann Whitney U test: 2 tailed p value < 0.01) and good correlations between the instrument and both the Malay version of BDI-II and the HRDS-17 (Spearman rank correlation coefficients of 0.78 and 0.88 respectively). At the 11/12 cut-off score the sensitivity of the EPDS is 100%, with a specificity of 98.18%, positive predictive value of 90%, negative predictive value of 100 % and misclassification rate of 1.56%.
CONCLUSION: This study confirmed the reliability and validity of the Malay version of the Edinburgh Postnatal Depression Scale in identifying postpartum depression among recently delivered Malay women attending the Bata Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia.
KEYWORDS: EPDS; postnatal depression; rating scale; validation
Study site: Klinik Kesihatan Bakar Bata, Alor Setar, Kedah, Malaysia

Matched MeSH terms: Depression, Postpartum*
Fulltext Reliability and validity of the malay version of Edinburgh Postpartum Depression Scale (EPDS) when administered to postpartum mothers at two points in time

Nursazila Asikin MA, Siti Norhani S, Nur Arzuar AR, Azam OE

International Medical Journal Malaysia, 2019;18:65-72.

Introduction: Edinburgh Postpartum Depression Scale (EPDS) is a tool used to assess the risk of postpartum depression (PPD). In this study we determined the reliability and validity of the Malay version of EPDS when administered at two different time points in the postpartum period.
Materials and Methods: This cross-sectional study design was carried out between May and September 2017 at three government primary healthcare clinics located in Batang Padang district, a suburban area of Perak state in Peninsular Malaysia. We recruited a total of 89 women; 41 women were in the early postpartum period (1-30 days) and 48 women were in the late postpartum period (31-120 days). Cronbach's alpha coefficient, inter-item correlation, and corrected item-total correlation were used to assess the internal consistency. The concurrent validity was assessed using Spearman's correlation. The data were analyzed using SPSS version 20 and R 3.4.2.
Results: The Cronbach's alpha for the first and second group was 0.78 and 0.62, respectively, which indicated satisfactory reliability. At both time periods, removing Item 2 from the scale resulted in a significant increase in Cronbach's alpha (to 0.847 and 0.709, respectively). As expected, the EPDS scores correlated moderately with the BDI-II scores (1-30 days: Spearman's rho = 0.65, p < 0.01; 31-120 days: Spearman's rho = 0.73, p < 0.01).
Conclusion: The Malay version of the EPDS is a reliable screening instrument for detecting postpartum depression. It showed reasonability and feasibility and can be used in postpartum clinical settings or for assessing intervention effects in research studies. Furthermore, as our results indicated, removing Item 2 from the Malay version would increase the internal consistency of the EPDS. © 2019 Default.
Study site: Klinik Kesihatan, Perak, Malaysia

Matched MeSH terms: Depression, Postpartum
Fulltext Relationship between obstetric risk factors and postnatal depression in Malaysian women

Abdul Kadir A, Mohammad Daud MN, Yaacob MJ, Nik Hussain NH

International Medical Journal (Tokyo), 2009;16:101-6.

Objective: To determine the prevalence of depressive symptomatology in early postnatal period and its relationship with obstetric risk factors. Material and Methodology: This is a cross sectional study involving 293 women from postnatal ward Hospital Universiti Sains Malaysia (HUSM), Malaysia. They were screened for depression at day 1 to day 5 postpartum and 4 to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). At the first visit, the women completed questionnaires on socio-demography and obstetric risk factors and Brief Patient Health Questionnaire (BPHQ-9). At the second visit which is 4-6 weeks postpartum, they only completed EPDS. Results: Two hundred and ninety-three women successfully completed the study (100% response rates). The prevalence of PND at 4-6 weeks postpartum using the EPDS score of 12 or more was 27.3%. Women with the history of abortion (p < 0.05) and early postnatal depression (p < 0.05) was significantly associated with PND. Conclusion: Postnatal depression among women in Hospital USM was more common compared to previously reported series in Malaysia. Women with the history of abortion and early postnatal depression were significantly associated with PND. © 2009 Japan International Cultural Exchange Foundation.

Matched MeSH terms: Depression, Postpartum
Fulltext Psychometric performance of the Medical Outcome Study (MOS) Social Support Survey among Malay postpartum women in Kedah, north west of Peninsular Malaysia

Wan Mahmud WMR, Amir A, Mahmood NM

Malaysian Journal of Psychiatry, 2004;12:38-44.

Aim: To evaluate the psychometric performance of the Malay version of the Medical Outcome Study (MOS) Social Support Survey among a sample of postpartum Malay women in Kedah, North West of Peninsular Malaysia.
Materials and methods: 354 women between 4 to 12 weeks postpartum were recruited for the validation study. They were given questionnaires on socio-demography, the Malay versions of the MOS Social Support Survey, the Edinburgh Postnatal Depression Scale (EPDS) and the 21-items Beck Depression Inventory-II (BDI-II). 30 of the participants, who were bilingual, were also given the original English version of the instrument. A week later, these women were again asked to complete the Malay version of MOS Social Support Survey.
Results: The median number for item 1 (the single item measure of structural support) was 3 (inter-quartile range = 2 - 4). Extraction method of the remaining 19 items (item 2 to item 20) using principle component analyses with direct oblimin rotation converged into 3 dimensions of functional social support (informational support, affectionate support / positive social interaction and instrumental support) with reliability coefficients of 0.93, 0.74 and 0.72 respectively. Overall the scale displayed good internal consistency (Cronbach's alpha = 0.93), parallel form reliability (0.98) and test-retest reliability (0.97) (Spearman's rho; p<0.01). Its validity was confirmed by the negative correlations between the overall support index (total social support score) and all the three dimensions of functional support with the Malay versions of EPDS and BDI-II. The overall support index also displayed low but significant correlations with the single measure structural social support in the instrument (Spearman's rho = 0.14; p <0.01).
Conclusions: The MOS Social Support Survey demonstrated good psychometric properties in measuring social support among postpartum Malay women in Kedah, North West of Peninsular Malaysia and could potentially be used as a simple instrument in primary care settings.

Matched MeSH terms: Depression, Postpartum
Fulltext Psychometric evaluation of the Medical Outcome Study (MOS) Social Support Survey among Malay postpartum women in Kedah, north west of Peninsular Malaysia

Mahmud WM, Awang A, Mohamed MN

Malays J Med Sci, 2004 Jul;11(2):26-33.
PMID: 22973124

The Malay version of the Medical Outcome Study (MOS) Social Support Survey was validated among a sample of postpartum Malay women attending selected health centers in Kedah, North West of Peninsular Malaysia. 215 women between 4 to 12 weeks postpartum were recruited for the validation study. They were given questionnaires on socio-demography, the Malay-versions of the MOS Social Support Survey, Edinburgh Postnatal Depression Scale (EPDS) and the 21-items Beck Depression Inventory-II (BDI-II). 30 of the women, who were bilingual, were also given the original English version of the instrument. A week later, these women were again given the Malay version of the MOS Social Support Survey. The scale displayed good internal consistency (Cronbach's alpha = 0.93), parallel form reliability (0.98) and test-retest reliability (0.97) (Spearman's rho; p<0.01). The negative correlations of the overall support index (total social support measure) with the Malay versions of EPDS and BDI-II confirmed its validity. Extraction method of the 19 items (item 2 to item 20) from the MOS Social Support Survey using principle axis factoring with direct oblimin rotation converged into 3 dimensions of functional social support (informational, affectionate / positive social interaction and instrumental support) with reliability coefficients of 0.91, 0.83 and 0.75 respectively. The overall support index also displayed low but significant correlations with item 1 which represents a single measure of structural social support in the instrument (p <0.01). The Malay version of the MOS Social Support Survey demonstrated good psychometric properties in measuring social support among a sample of Malay postpartum Malay women attending selected health centers in Kedah, North West of Peninsular Malaysia and it could be used as a simple instrument in primary care settings.

Matched MeSH terms: Depression, Postpartum
Fulltext Prevalence and risk factors of postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) among mothers during their 4-week postnatal follow-up in five public health clinics in Perak: A study protocol for a cross-sectional study

Mohammad Redzuan SA, Suntharalingam P, Palaniyappan T, Ganasan V, Megat Abu Bakar PN, Kaur P, et al.

BMJ Open, 2020 06 21;10(6):e034458.
PMID: 32565453 DOI: 10.1136/bmjopen-2019-034458

INTRODUCTION: Postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) are often overlooked, and may cause morbidity to new mothers, their babies and families. This study aims to determine the point prevalence of depression (post partum and general), anxiety and stress among mothers in five public health clinics in Perak at 4 weeks postdelivery and identify their associated risk factors. Findings from this study will be used to identify the needs for early screening and detection, encourage development of interventions to reduce its occurrence and support mothers with PODSAS.
METHODS AND ANALYSIS: This cross-sectional study will recruit 459 postpartum mothers during their 4-week postnatal follow-up in five selected public health clinics in Perak from September 2019 to May 2020. Participants will be mothers aged 18 years and above at 4 weeks postdelivery who are able to understand the English and Malay languages. Non-Malaysians and mothers with known diagnosis of psychotic disorders will be excluded from the study. Sociodemographic information and possible risk factors of the participants will be captured via a set of validated questionnaires, postpartum depression (PPD) will be measured using the Edinburgh Postpartum Depression Scale questionnaire and general depressive symptoms, anxiety and stress will be measured using the 21-item Depression, Anxiety and Stress Scale. Data analysis will be conducted using SPSS V.25.0 (IBM). Besides descriptive statistics, multivariable regression analyses will be done to identify possible risk factors and their independent associations with depression (PPD and general depressive symptoms, combined and separately), anxiety and stress.
ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the Medical Research Ethics Committee, Ministry of Health Malaysia on 7 August 2019. Results of this study will be reported and shared with the local health stakeholders and disseminated through conference proceedings and journal publications.
REGISTRATION NUMBER: This study is registered in the Malaysian National Medical Research Register with the ID: NMRR-19-868-47647.

Matched MeSH terms: Depression, Postpartum

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