Development and validation of a three‐item version of the Edinburgh Postnatal Depression Scale

Abstract

Objective To develop and validate a brief screening instrument for postpartum depression in resource‐constrained primary care settings. Method Secondary data analysis of a cohort of 305 mothers (Mdnage = 26) attending well‐child check‐ups in six primary care centers in Santiago, Chile, answered the Edinburgh Postnatal Depression Scale (EPDS), the 36‐Item Short Form Health Survey, and the Mini International Neuropsychiatric Interview depression module. A predictive model for postpartum depression was built using logistic and least absolute shrinkage and selection operator regressions, with bootstrap validation. Results A three‐item version of the EPDS exhibited excellent discriminative capacity (c statistic = 0.95) and showed no significant differences versus the full version of the EPDS (χ2(1) = 1.75, p = .187). The best trade‐off between sensitivity (92.86%) and specificity (86.70%) was achieved at a cut‐off score of 8/9. Conclusions The three‐item version of the EPDS can save clinicians valuable time, which might potentially improve communication of results to patients.

Marital adjustment and depressive symptoms among Chinese perinatal women: a prospective, longitudinal cross-lagged study

“…For example, Bowen et al 43 found a declining trend in the prevalence of depressive symptoms among Canadian women during pregnancy. Martinez et al 48 found a significantly increasing trend of depressive symptoms among women in the USA, while Lau et al 30 found a subtle decreasing–increasing trend among Chinese women. The inconsistent pattern of depressive symptoms may be due to differences in cultural backgrounds 45.…”

Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS‐Dep‐5

“…Most existing studies developing shortened EPDS forms compared the shortened forms to the full EPDS rather than comparing to diagnostic classification for depression. Only three studies validated their shortened forms against major depression classification based on DSM or ICD diagnostic criteria, but these studies included only 63, 19, and 9 major depression cases, 20,22,24 limiting their ability to draw conclusions about the shortened scales' measurement properties. Table 1 presents the items included in each study's shortened form as well as the methods used to create that version.…”

“…Shortened forms of the full 10-item EPDS have been developed Table 1. [19][20][21][22][23][24] These include two two-item forms, 19,24 a five-item form, 20 three-and seven-item subscales that measure symptoms of anxiety and depression separately, 21,24 a three-item form, 22 and an eight-item form. 23 None of the development processes for these shortened forms used pre-specified criteria for performance to determine how many items to remove from the full 10-item EPDS.…”

“…23 None of the development processes for these shortened forms used pre-specified criteria for performance to determine how many items to remove from the full 10-item EPDS. Furthermore, only three studies shortening the EPDS validated against major depression classification status, 20,22,24 and these studies included only 63, 19, and 9 major depression cases. The extent to which the existing shortened forms retain the measurement and diagnostic properties of the full scale is unclear.…”

“…Shortened forms of the full 10‐item EPDS have been developed Table 1 19–24 . These include two two‐item forms, 19,24 a five‐item form, 20 three‐ and seven‐item subscales that measure symptoms of anxiety and depression separately, 21,24 a three‐item form, 22 and an eight‐item form 23 .…”