A written consent, approved by the Research Ethic Committee of Isfahan

University of Medical Sciences, was obtained from all of the participants. Afterwards, a semi-structured interview was done with participants by a clinical psychologist using HDRS in a relaxed and private situation in health centers in the 5-FU ic50 absence of any other person including their husbands and other family members. Then after a break of 15 minute, they filled Inhibitors,research,lifescience,medical EPDS as a self-report scale. Data were analyzed using Statistical Package for Social Sciences (SPSS, version 15). Cronbach’s alpha was used to assess the reliability of the EPDS and Pearson coefficient was used to determine the face and content validity of HDRS. Calculation of Z and T Inhibitors,research,lifescience,medical was used to determine of standard scores. For classifying the factors related to the items of the questionnaires, explanatory factor analysis was used with Eigen value greater than 1. Receiver operating characteristic

(ROC) curves was used to find an optimum sensitivity, specificity and cut-off point based on a semi-structured clinical interview using HDRS as gold standard. Results Two hundred seventy postpartum mothers aged 18-45 years possessing the inclusion criteria were enrolled in this study. Eight of the participants were excluded from the study for different reasons including suspected psychosis or mental retardation, lack of reliability, Inhibitors,research,lifescience,medical or mood affecting medications. The age of the participants was 26.6±5.1 years (CI 95%: 25.9, 27.2). The Inhibitors,research,lifescience,medical time after delivery in non-depressed and depressed women were 52.5±27.2 months (CI 95%: 48.9, 56.1) and 56.4±27.3 months (CI 95%: 50.5, 62.3), respectively. Table 1 summarizes the frequency (%) of distribution some of the characteristics of postpartum

women based on HDRS. Based on a cut-off point of 13, HDRS showed that 18.3% of the participants were depressed. Table 1 The number and percentage (%) of distribution of some of the characteristics of postpartum women in the study based on Hamilton Inhibitors,research,lifescience,medical Depression Rating Scale The mean score of EPDS in this study was 10.2±5.3, and scale reliability calculated using Cronbach’s alpha was 0.791. Cronbach’s alpha range calculated by omitting each question ranged between 0.76-0.79. There was a significant correlation between EPDS and HDRS (r=0.62, P<0.001). Kaiser-Meyer-Olkin index for adequacy Endonuclease of sample size was 0.84 with Bartlell’s test of sphericity (X2=530, df=45, P<0.001). Explanatory factor analysis was done with Varimax rotation and two factors were extracted using principal component analysis method. On the whole, these two factors determined 62% of variance in all the questions (46.4 for depression item and 15.6 for anhedonia item). Table 2 shows these factors and their loads. Table 2 Explanatory factor loads for depression and anhedonia (the first and second factor) of the Edinburgh Postnatal Depression Scale. The T scores varied from 30.66 to 81.70, and Z scores were between -1.09 and 3.17.