Validity of postpartum depression screening across socioeconomic groups: a review of the construct and common screening tools.

This integrative literature review evaluates the construct validity and potential for bias of commonly used postpartum depression screening tools in women with low socioeconomic status. Multiple search strategies were applied to identify literature addressing the validity of the Beck Depression Inventory, Center for Epidemiological Studies-Depression Scale, Edinburgh Postnatal Depression Scale, and Postpartum Depression Screening Scale from January 1980 thru January 2010. Twenty articles were identified, eight of which explicitly included women with low-socioeconomic status. Only three of these articles directly evaluated construct validity. The screening tools reviewed lack the comprehensive psycho-metric evaluation needed to support their extensive use across socioeconomically diverse populations that may result in missed opportunities to identify postpartum depression. This issue stems from serious limitations in the understanding of postpartum depression itself. An alternate understanding of and approach to screening for depression across all women in their developmental and environmental context is recommended.