Validation of the Hindi version of the Edinburgh postnatal depression scale (EPDS): Translation, cross-cultural adaptation, and psychometric evaluation in postpartum mothers.

BACKGROUND

Postpartum depression (PPD) is a significant global public health concern, with a high prevalence in India. While the EPDS is widely used, there is a lack of rigorous validation studies specifically for Hindi-speaking postpartum mothers.

AIM: This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Hindi EPDS in postpartum mothers against a clinical diagnosis.

METHODS

An observational study was conducted at a tertiary care hospital involving 181 mothers, 48 hours to 7 days after childbirth. The original English EPDS underwent a five-stage translation and adaptation process, including independent forward and back-translations and expert committee reviews. Validity was assessed against a clinical diagnosis made by a psychiatrist. Statistical analysis included Cronbach's alpha for internal consistency, Principal Axis Factoring with Promax rotation for construct validity, and receiver operating characteristic (ROC) curve analysis to determine the optimal cut-off score.

RESULTS

The prevalence of depression in the cohort was 26.0% (47/181). Hindi EPDS showed good internal consistency (Cronbach's α =0.859) and demonstrated good diagnostic accuracy with an Area Under the Curve (AUC) of 0.912. At an optimal cut-off score of 9, the scale showed a sensitivity of 70.2% and a specificity of 91.8%. Factor analysis revealed a three-factor structure: Anxiety, Depressed Affect, and Anhedonia, which accounted for 62% of the total variance.

CONCLUSIONS

The Hindi version of the EPDS is a valid, reliable, and culturally sensitive tool for screening postpartum depression in Indian tertiary care settings. A threshold score of nine is recommended for identifying at-risk mothers, enabling clinicians to apply cultural formulations for mothers facing significant neonatal stressors or breastfeeding difficulties.