A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women

Abstract

Objective: The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening tool for postpartum depression (PPD). We systematically reviewed the published evidence on its validity in detecting PPD and antepartum depression (APD) up to July 2008. Method: Systematic review of validation studies of the EPDS included 1987-2008. Cut-off points of 9 ⁄ 10 for possible PPD, 12 ⁄ 13 for probable PPD and 14 ⁄ 15 for APD were used. Results: Thirty-seven studies met the inclusion criteria. Sensitivity and specificity of cut-off points showed marked heterogeneity between different studies. Sensitivity results ranged from 34 to 100% and specificity from 44 to 100%. Positive likelihood ratios ranged from 1.61 to 78. Conclusion: Heterogeneity among study findings may be due to differences in study methodology, language and diagnostic interview ⁄ criteria used. Therefore, the results of different studies may not be directly comparable and the EPDS may not be an equally valid screening tool across all settings and contexts. Summations• There is a wide variation across different settings in sensitivity, specificity, positive and negative likelihood ratios in validation studies of the Edinburgh Postnatal Depression Scale (EPDS).• Differences in methodology of the included studies are likely to account for the variation in results.• There are only three studies evaluating the EPDS for use in antenatal populations. Considerations• Because of considerable differences in the methodology of included studies, quantitative approaches using meta-analysis were not performed.

Anticipated Negative Police-Youth Encounters and Depressive Symptoms among Pregnant African American Women: A Brief Report

“…The EPDS has been widely validated as a measure for detecting depressive symptoms (loss of interest, guilt feelings, sleep disturbances, and suicide ideation) during the antenatal and postpartum periods [24]. The 10-item scale is scored by adding the responses from each item; scores of 10 or greater indicate possible depression [27,28]. The Cronbach alpha for this study was 0.88.…”

Inconsolable Infant Crying and Maternal Postpartum Depressive Symptoms

“…episodes (sensitivity 59%-100% vs 34%-100% for cutoff of 12) without significantly compromising specificity (44%-97% vs 49%-100% for a cutoff of 12). 24 We chose to use the 9 cutoff a priori for these reasons. In addition, our measure of infant colic was an average of infant distress over 1 to 4 days of recording, rather than using Wessel' s method of measurement over 3 weeks, so some misclassification of exposure is possible.…”

“…23,24 The EPDS score is a sum of responses to 10 questions about mood and self-harm ideation by using a 2-week recall. A score .12 is considered a positive screen indicative of clinically significant maternal depression, whereas a score of 9 or greater is considered "possible depression."…”

Association between mothers’ and fathers’ depressive symptoms, sense of coherence and perception of their child’s temperament in early parenthood in Sweden

“…To estimate each parent's level of post-partum depressive symptoms, all questions in the EPDS had to be answered. The scale has been validated in mothers [17,21] and fathers [22]. Cox et al [17] recommended a cut-off of >9 to identify a risk for depression and a cut-off of >11 to identify depressive illness of varying severity [17].…”