Establishing a coherent and replicable measurement model of the Edinburgh Postnatal Depression Scale

Martin, Colin R.; Redshaw, Maggie

doi:10.1016/j.psychres.2018.03.062

Cited by 22 publications

(20 citation statements)

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“…One of our inclusion criteria was that the mother had an infant between 2 and 10 months and although the majority (83%) of the T2 assessments were conducted between 8 and 20 weeks postpartum, T2 assessments were conducted with a quite wide timeframe (Table 1). Recently, a paper by Martin and Redshaw reported that mothers, who did not differ on other background variables, scored significantly different on the EPDS at three and six months postpartum [43]. However, based on the current data, it is not possible to address the question of whether an EPDS-score obtained for example at two months postpartum is more or less likely to reflect an underlying depression than at a later time point in the postpartum period.…”

Section: Discussionmentioning

confidence: 74%

“…More recently, a researchers have questioned the utility of continously conducting EFA as opposed to data and theory-driven confirmatory factor analyses (CFAs), (e.g. [40, 43]) and related to this, the optimal length of the EPDS has been questioned [44]. However, as there is currently no genereally agreed upon factor structure that could serve as the basis for a CFA, in the present study, we decided to assesss the factor structure of the EPDS using EFA.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression

et al. 2018

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BackgroundThe Edinburgh Postnatal Depression Scale (EPDS) is widely used in many countries to screen women for depression in the perinatal period. However, across studies the psychometric properties and cutoff scores of the EPDS have varied considerably; potentially due to different depression criteria and diagnostic systems being used. Therefore, we validated the Danish EPDS against a depression diagnosis according to both DSM-5 and ICD-10. Furthermore, we examined whether the Danish EPDS is multidimensional, as it has previously been suggested.MethodsWomen (N = 324) were recruited after routine screenings with the EPDS between 2 and 10 months postpartum (T1). At a subsequent home visit (T2), the EPDS and the Structured Clinical Interview for DSM-5 were administered. Diagnostic interviews were audio recorded to enable subsequent coding for ICD-10 diagnoses and inter-rater reliability analysis. A two-phase stratified sampling strategy with three sampling categories (EPDS-score at T1) was used. Using the distribution of 4931 T1 EPDS-scores from the same population from which we sampled the participants, we used sampling weighing to reweight the sample. The calculation of weights was based upon the mother’s sampling category at T1 (i.e. the probability of being sampled) and the weights were applied when assessing the receiver operation characteristics (ROCs) of the EPDS. Sensitivity, specificity, positive predictive value, negative predictive value and area under the ROC curve were computed from the reweighted data for all relevant cutoff values. CIs were computed by embedding the calculations in a weighted logistic regression. Exploratory factor analysis was done using oblique rotation. Parallel analysis was used to assess the number of factors.ResultsA score of 11 or more was found to be the optimal cutoff for depression according to both DSM-5 and ICD-10 criteria. Factor analysis suggested that the Danish EPDS consists of three factors, including an ‘anxiety factor’.ConclusionsThe Danish EPDS has reasonable sensitivity and specificity at a cutoff score of 11 or more. There are no notable differences with respect to using ICD-10 or DSM-5 criteria for depression in terms of optimal cutoff. The variation in cutoff scores is likely to be due to cultural variations in the expression of depressive symptoms.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1965-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression

et al. 2018

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“…CFA was conducted on the remaining 60% of the data using Weighted Least Squares Mean and Variance (WLSMV), which uses polychoric correlations and robust corrections to account for ordinal and non-normally distributed data (e.g., Lydsdottir et al, 2019, Albuquerque et al2017, Martin and Redshaw, 2018. As much of the previous literature has used MLE, we also performed CFA using this method, and are reporting the results in the…”

Section: Cfamentioning

confidence: 99%

“…We considered it was essential to report the frequency of responses per each individual EPDS item, as recent studies have highlighted the need for this information (Martin 2018) in order to better understand the distributional characteristics of EPDS items…”

Section: Frequency Of Responses Per Each Individual Item Of the Epdsmentioning

confidence: 99%

“…Other studies have used various methods including polychoric correlation matrices (Lydsdottir et al, 2019), or Pearson correlation matrices with Maximum Likelihood Extraction (MLE, Kubota et al, 2014, Phillips et al, 2009, Stasik-O'Brien et al, 2019, Coates et al, 2017, Kubota et al, 2018, Ordinary Least Squares (Chiu et al, 2017), or Principal Axis Factoring (Tuohy et al, 2008, Pop et al, 1992. CFA studies have used either MLE (Zhong et al, 2014, Flom et al, 2018, Hartley et al, 2014, Kozinsky and Dudas, 2015 or Weighted Least Squares methods (Jomeen and Martin, 2007, Kwan et al, 2015, Lydsdottir et al, 2019, King, 2012, Gutierrez-Zotes et al, 2018, Martin and Redshaw, 2018. The variability in methodology may explain differences in results reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

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The factor structure of the Edinburgh Postnatal Depression Scale among perinatal high-risk and community samples in London

Lautarescu¹,

Victor²,

Lau‐Zhu³

et al. 2020

Preprint

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Background: Timely and accurate detection of perinatal mental health problems is essential for the wellbeing of both mother and child. Growing evidence has suggested that the Edinburgh Postnatal Depression Scale (EPDS) is not a unidimensional measure of perinatal depression, but can be used to screen for anxiety disorders.Methods: We aimed to assess the factor structure of the EPDS in 3 different groups of women: n=266 pregnant women at high-risk of depression (“Perinatal Stress Study”), n=471 pregnant women from a community sample, and n=637 early postnatal women from a community sample (“developing Human Connectome Project”). Exploratory factor analysis (40% of each sample) and confirmatory factor analysis (60% of each sample) were performed. The relationship between EPDS scores and history of mental health was investigated. Results: Results suggested that a 3-factor model (depression, anxiety, and anhedonia) is the most appropriate across groups. The anxiety subscale (EPDS 3A) emerged consistently and was related to maternal history of anxiety disorders. Total EPDS score was related to history of mental health problems. Limitations: Although data were collected on maternal history of mental health, there was no standardized diagnostic interview administered to assess the relationship between EPDS 3A and a current diagnosis of anxiety disorder. Conclusions: A better understanding of the multi-factorial structure of the EPDS can inform diagnosis and management of women in the prenatal and postnatal period. The EPDS 3A could be used to provide initial screening information for anxiety in situations where a validated anxiety questionnaire is not administered.

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Maternal postpartum depression is a risk factor for infant emotional variability at 4 months

Væver

Egmose

Smith‐Nielsen

et al. 2020

Infant Mental Health Journal

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Establishing a coherent and replicable measurement model of the Edinburgh Postnatal Depression Scale

Cited by 22 publications

References 56 publications

Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression

Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression

The factor structure of the Edinburgh Postnatal Depression Scale among perinatal high-risk and community samples in London

Maternal postpartum depression is a risk factor for infant emotional variability at 4 months

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