Cross-Cultural Adaptation of the Edinburgh Postnatal Depression Scale

The Need for Culturally Appropriate Psychosocial Screening Tools: Mental health issues, like anxiety or depression, affect people across the globe. While these conditions are common worldwide, they are experienced and expressed very differently. Research shows that a person’s culture significantly affects how they experience depression, what symptoms they show, and what kind of help they seek. In some languages, there is not even a word for ‘depression’, and people instead experience ‘deep sadness’ or ‘a poor heart’. This means that screening for depression across different cultural groups can be challenging. Psychosocial screening tools need to be culturally adapted to establish cultural equivalence – not just translated (mere semantic equivalence) – in order to adequately screen for depression in a target cultural group. Our research team has been working to adapt the Edinburgh Perinatal Depression Scale (EPDS) specifically for Indigenous women in Canada.

The EPDS is a questionnaire that is used to screen for depression during pregnancy and postpartum. It has been translated into 58 languages and used worldwide. Many screening tools for depression often ask about symptoms such as difficulty sleeping or loss of appetite - both of which are common problems during pregnancy. The EPDS avoids conflating symptoms of depression with normal pregnancy- and childbirth-related physiological changes by explicitly linking conditions such as sleeplessness to mood or emotions (e.g., sadness). This makes the EPDS a suitable screening tool for perinatal depression that is sensitive to the unique and changing experiences of pregnancy and childbirth.

In partnership with the Cree Board of Health and Social Services of James Bay (CBHSSJB) and the Nunavik Regional Board of Health and Social Services (NRBHSS), our team has cross-culturally adapted the EPDS into two dialects of Eastern James Bay Cree (EPDS-Cree) and two dialects of Inuktitut spoken in Nunavik (EPDS-Inuktitut). The EPDS-Cree and EPDS-Inuktitut are the only perinatal depression screening tools that have been cross-culturally adapted for Indigenous communities in Canada.

EPDS-Inuktitut: Our team has pilot tested the EPDS-Inuktitut with over 120 Inuit women of childbearing age in Montreal and Nunavik. We are currently conducting a full validation study of the EPDS-Inuktitut with pregnant and postpartum women from Nunavik as part of the Irnisursiriartutuq Nunaringngitamini project. The study is funded by the Canadian Institutes for Health Research (CIHR).

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