Patient health questionnaire-9 versus Edinburgh postnatal depression scale in screening for major depressive episodes: a cross-sectional population-based study

Abstract

BackgroundMajor depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh postnatal depression scale (EPDS).MethodsIn a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant’s home.Results447 individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5 % of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1 % for PHQ-9 and 83.5 % for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy.ConclusionsPHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health Centre of Nairobi

“…SPSS version 22 [ 43 ] was used in data analysis. The association between depression and its psychosocial correlates was determined in two ways.…”

Addressing maternal depression in home visiting: Findings from the home visiting collaborative improvement and innovation network

“…(PHQ-9 was used when PHQ-2 was positive.) "Positive" screens were defined using the cutoff for mild or greater depressive symptoms specific to each tool: � 10 on the EPDS and � 10 on PHQ-9 [51,52]; these cutoffs were established to include women likely exhibiting major depression and subclinical depression (or, as it is sometimes referred to, minor depression) given emerging research indicating that many of the same negative maternal and child health outcomes occur not only among women exhibiting major depression, but also women with subclinical symptoms [14]. The working definition of "access services" required a client to have at least one contact with an evidence-based service provider.…”

Cognitive testing of the PHQ-9 for depression screening among pregnant and postpartum women in Kenya

“…We did not conduct follow-up cognitive interviews with the revised PHQ-9 or compare PHQ-9 scores with the EPDS, also commonly used for perinatal depression screening. However, recent studies have found that the EPDS performs similarly to the PHQ-9 in pregnant and postpartum populations [23][24][25]. Future large-scale validation studies comparing the revised PHQ-9 to clinical diagnostic interviews for MDD diagnosis among pregnant and postpartum women in East Africa are necessary.…”

“…The Edinburgh Postnatal Depression Scale (EPDS) has also been widely used among populations of pregnant and postpartum women, with high sensitivity and specificity for detecting major depressive disorder in this population, and may have advantages over the PHQ-9 for detecting perinatal depression because the scale does not include somatic depressive symptoms which could relate to either depression or pregnancy (e.g., changes in appetite or sleeping) [22]. However, while the PHQ-9 has been less frequently used among pregnant and postpartum women [22], several studies have found similar sensitivity and specificity estimates for the PHQ-9 and the EPDS suggesting that women are able to disentangle pregnancy symptoms from somatic depressive symptoms [22][23][24][25]. Moreover, because PHQ-9 is often used in the general population, depression screening with the PHQ-9 can facilitate comparisons between pregnant and postpartum women and other groups of women.…”