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, and Deborah F. Perry

Brief Type

Journal publication



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 below 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) N 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. (author abstract)

Data Collection Methods

  • Interviews
  • Standardized assessment tools
  • Surveys or questionnaires



For More Information

Tandon, S. D., Cluxton-Keller, F., Leis, J., Le, H. N., & Perry, D. F. (2012). A comparison of three screening tools to identify perinatal depression among low-income African American women. Journal of Affective Disorders, 136(1-2), 155-162. https://doi.org/10.1016/j.jad.2011.07.014
Author Contact Information:
S. Darius Tandon


  • Participant Characteristics
  • Participant, Family, and Program Outcomes