Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS:Systematic Review and Individual Participant Data Meta-analysis

Objective:The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores >= 7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 >= 7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).Methods:We searched Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and the Web of Science Core Collection through June 2016 for studies with data sets with item response data to calculate EPDS-5 scores and that used the SCID to ascertain depression status. We conducted an individual participant data meta-analysis to estimate pooled percentage of EPDS-5 >= 7, pooled SCID major depression prevalence, and the pooled difference in prevalence.Results:A total of 3,958 participants from 19 primary studies were included. Pooled prevalence of SCID major depression was 9.2% (95% confidence interval [CI] 6.0% to 13.7%), pooled percentage of participants with EPDS-5 >= 7 was 16.2% (95% CI 10.7% to 23.8%), and pooled difference was 8.0% (95% CI 2.9% to 13.2%). In the 19 included studies, mean and median ratios of EPDS-5 to SCID prevalence were 2.1 and 1.4 times.Conclusions:Prevalence estimated based on EPDS-5 >= 7 appears to be substantially higher than the prevalence of major depression. Validated diagnostic interviews should be used to establish prevalence

Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis

Objective:The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores >= 7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 >= 7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).Methods:We searched Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and the Web of Science Core Collection through June 2016 for studies with data sets with item response data to calculate EPDS-5 scores and that used the SCID to ascertain depression status. We conducted an individual participant data meta-analysis to estimate pooled percentage of EPDS-5 >= 7, pooled SCID major depression prevalence, and the pooled difference in prevalence.Results:A total of 3,958 participants from 19 primary studies were included. Pooled prevalence of SCID major depression was 9.2% (95% confidence interval [CI] 6.0% to 13.7%), pooled percentage of participants with EPDS-5 >= 7 was 16.2% (95% CI 10.7% to 23.8%), and pooled difference was 8.0% (95% CI 2.9% to 13.2%). In the 19 included studies, mean and median ratios of EPDS-5 to SCID prevalence were 2.1 and 1.4 times.Conclusions:Prevalence estimated based on EPDS-5 >= 7 appears to be substantially higher than the prevalence of major depression. Validated diagnostic interviews should be used to establish prevalence

Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: An individual participant data meta‐analysis

OBJECTIVES: A previous individual participant data meta-analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire-9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum. METHODS: Data accrued for an EPDS diagnostic accuracy IPDMA were analysed. Binomial generalised linear mixed models were fit to compare depression classification odds for the Mini International Neuropsychiatric Interview (MINI), Composite International Diagnostic Interview (CIDI), and Structured Clinical Interview for DSM (SCID), controlling for EPDS scores and participant characteristics. RESULTS: Among fully structured interviews, the MINI (15 studies, 2,532 participants, 342 major depression cases) classified depression more often than the CIDI (3 studies, 2,948 participants, 194 major depression cases; adjusted odds ratio [aOR] = 3.72, 95% confidence interval [CI] [1.21, 11.43]). Compared with the semistructured SCID (28 studies, 7,403 participants, 1,027 major depression cases), odds with the CIDI (interaction aOR = 0.88, 95% CI [0.85, 0.92]) and MINI (interaction aOR = 0.95, 95% CI [0.92, 0.99]) increased less as EPDS scores increased. CONCLUSION: Different interviews may not classify major depression equivalently

The communicative competence of young French-English bilingual children /

The communicative competence of bilingual children involves a large array of skills---they must not only acquire the full range of communication skills of monolinguals but also learn when, how and with whom to use each language. This dissertation features three studies on the communication skills of bilingual children (French-English bilinguals aged 2.5 and 3 years from the Montreal area). Studies 1 and 2 explored these children's ability to make appropriate language choices by studying their responsiveness to two types of cues: The first study investigated whether children's language choice is influenced by their interlocutor's code-mixing; the second study examined whether children change their language in response to their interlocutor's requests for clarification following the children's use of the inappropriate language. The children demonstrated that they were capable of making on-line adjustments in their language choice in response to both types of cues, thereby showing that sensitivity to cues for language change is part of bilingual children's communicative competence from a young age. Study 3 compared bilingual and monolingual children's responses to requests for clarification following breakdowns in communication due to problematic aspects of their utterances such as speaking too softly or mispronouncing words. The findings revealed no significant differences between the bilingual and monolingual children's responses and suggest that the acquisition of conversational repair skills is not influenced by the simultaneous acquisition of two languages. Together, these three studies contribute to the understanding of the skills underlying children's ability to make appropriate language choices and suggest that the unique demands of bilingual interpersonal communication do not interfere with the acquisition of more general communication skills

Celebrating 70 years of IUHPE’s role in advancing global health promotion

Commemorative event for the 70th anniversary of the role of the IUHPE in advancing global health promotionActe commemoratiu dels 70 anys del paper de l’IUHPE en l’avanç de la promoció mundial de la salu

The IUHPE Health Promotion Accreditation System – developing and maintaining a competent health promotion workforce

This commentary reports on the development and implementation of the competency-based IUHPE Health Promotion Accreditation System in the context of workforce capacity as a key activity of the International Union for Health Promotion and Education (IUHPE). The process of developing the System is described, including how it built on, and added to, international research and experience in competency-based approaches to health promotion. An overview of how the System works, its current status and future plans, is presented. Evidence of the positive impact of the System to date, in particular in the context of health promotion education, is considered

A health promotion focus on COVID-19: Keep the Trojan horse out of our health systems. Promote health for ALL in times of crisis and beyond!

PREFACE Ongoing discussion about the range of actions needed during the SARS-CoV-2 outbreak and Coronavirus Disease 2019 (COVID-19) is calling all of us to bring forward our thoughts and experiences about how best to cope with the multiple challenges we are facing regarding COVID-19. We would like to share the following five talking points that could evolve into a more refined and targeted public health discussion on the implications of this pandemic, from a health promotion perspective. As discussions worldwide bring topics such as health, equity, sustainability, solidarity or human dignity to a new level of implications, a systematic perspective is missing to bring these themes together with the disease prevention and curative efforts in the public health framework. This is where health promotion has the expertise to bring these extremely relevant issues together, to offer a comprehensive approach, in a common effort to support the medical care systems to face the sudden burden that was laid in their hands

A health promotion focus on COVID-19: Keep the Trojan horse out of our health systems. Promote health for ALL in times of crisis and beyond!

PREFACE Ongoing discussion about the range of actions needed during the SARS-CoV-2 outbreak and Coronavirus Disease 2019 (COVID-19) is calling all of us to bring forward our thoughts and experiences about how best to cope with the multiple challenges we are facing regarding COVID-19. We would like to share the following five talking points that could evolve into a more refined and targeted public health discussion on the implications of this pandemic, from a health promotion perspective. As discussions worldwide bring topics such as health, equity, sustainability, solidarity or human dignity to a new level of implications, a systematic perspective is missing to bring these themes together with the disease prevention and curative efforts in the public health framework. This is where health promotion has the expertise to bring these extremely relevant issues together, to offer a comprehensive approach, in a common effort to support the medical care systems to face the sudden burden that was laid in their hands.non-peer-reviewe