Factor Structure of the Edinburgh Postnatal Depression Scale in a Sample of Postpartum Slovak Women

Abstract

Background: Postpartum depression has a negative impact on quality of life. The aim of this study was to examine the factor structure and psychometric properties of the Slovak version of the Edinburgh Postnatal Depression Scale (EPDS). Methods: A paper and pencil version of the 10-item EPDS questionnaire was administered personally to 577 women at baseline during their stay in hospital on the second to fourth day postpartum (age, 30.6 ± 4.9 years; 73.5% vaginal births vs. 26.5% operative births; 59.4% primiparas). A total of 198 women participated in the online follow-up 6–8 weeks postpartum (questionnaire sent via e-mail). Results: The Slovak version of the EPDS had Cronbach’s coefficients of 0.84 and 0.88 at baseline (T1) and follow-up, respectively. The three-dimensional model of the scale offered good fit for both the baseline (χ2(df = 28) = 1339.38, p < 0.001; CFI = 0.99, RMSEA = 0.02, and TLI = 0.99) and follow-up (χ2(df = 45) = 908.06, p < 0.001, CFI = 0.93, RMSEA = 0.09, and TL = 0.90). A risk of major depression (EPDS score ≥ 13) was identified in 6.1% in T1 and 11.6% in the follow-up. Elevated levels of depression symptoms (EPDS score ≥ 10) were identified in 16.7% and 22.7% of the respondents at baseline and follow-up, respectively. Conclusions: The Slovak translation of the EPDS showed good consistency, convergent validity, and model characteristics. The routine use of EPDS can contribute to improving the quality of postnatal health care.

The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic

“…In addition, it has been proven that Slovak family members of patients in intensive care units report a higher prevalence of depression ( 15 ), which can also be expected in COVID-19 disease. Young people, patients as well as females can be considered as risk and vulnerable groups in this country ( 16 – 20 ). On the other hand, there is little evidence among the general Slovak population, which was confirmed by the results of a new international study conducted by Zhang et al ( 21 ).…”

Can EPDS and EPDS‐3A be used to replace GAD‐7 to screen the anxiety of pregnant women during pregnancy examination?

“…In a study on a Chinese sample, a three-factor model containing anhedonia, anxiety, and depression was found, 23 in which the anxiety factor consisted of items 3, 4, and 5, called the EPDS-3A, which was consistent with most other studies. 14,15,19,20 However, the screening ability of the EPDS-3A for perinatal anxiety was inconsistent across previous studies. Some studies revealed that the EPDS-3A score was more correlated with the anxiety score than with the depression score, 26 and the EPDS-3A had a certain application value in screening for perinatal depression and anxiety.…”

“…7,13 In addition, in recent years, researchers also found that the EPDS can be divided into several independent dimensions, some of which can be used as subscales instead of the total scale to measure depressive symptoms of pregnant women, and their misdiagnosis rates are low. [14][15][16][17][18][19][20][21][22][23][24] Another researcher suggested that item scores of the anxiety subscale were generally higher than those of other subscales, indicating that perinatal depression consists mainly of anxiety symptoms. 16 These results illustrate the possibility of only using the shorter anxiety subscale of the EPDS to screen the anxiety of pregnant women without using an additional anxiety scale in pregnancy examinations.…”

“…However, there was a discrepancy in the factor structure of the EPDS in previous studies. Most studies showed that an anxiety subscale included items 3, 4, and 5, 3,10,14,15,19,20,23,25 but others suggested that an anxiety subscale should include other items, or that there is no separate anxiety dimension in the EPDS at all. 9,16,21,22,24 The differences in results might be due to the diversity of socioeconomic and cultural background of the study samples, the translated versions of the EPDS, and the time points of measurement during the perinatal period.…”

“…In addition, in recent years, researchers also found that the EPDS can be divided into several independent dimensions, some of which can be used as subscales instead of the total scale to measure depressive symptoms of pregnant women, and their misdiagnosis rates are low 14–24 . Another researcher suggested that item scores of the anxiety subscale were generally higher than those of other subscales, indicating that perinatal depression consists mainly of anxiety symptoms 16 .…”