Detection of postnatal depression. Development of the Edinburgh Postnatal Depression Scale (EPDS)

Department of Postgraduate Medicine, University of Keele, Stoke-on-Trent, Staffs.
The British Journal of Psychiatry (Impact Factor: 7.99). 07/1987; 150(6):782-6. DOI: 10.1192/bjp.150.6.782
Source: PubMed


The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.

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    • "SD = 4.80); higher scores indicate greater symptom severity. Fifty-six percent scored in the " probable " depression rate, with scores > 12 (Cox et al., 1987). Women were assessed for PTSD symptoms with the Modified PTSD Symptom Scale – Self Report (MPSS-SR; Falsetti, Resnick, Resick & Kilpatrick, 1993), measuring the frequency (0-3 scale) of symptoms present for the past two weeks, and summed to create a total score (x ̅ = 10.04, "
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    ABSTRACT: Prenatal stress negatively affects fetal development, which in turn may affect infant hypothalamic-pituitary adrenal (HPA) axis regulation and behavioral functioning. We examined effects of exposure to a traumatic stressor in families [intimate partner violence (IPV)] on both infants' HPA axis reactivity to stress and their internalizing and externalizing behaviors. Infants (n= 182, 50% girls, x age = 11.77 months) were exposed to a laboratory challenge task designed to induce frustration and anger (i.e., arm restraint). Saliva samples were taken pre-task and 20 and 40 minutes post-task and then assayed for cortisol. Mothers reported on their pregnancy and postpartum IPV history, current mental health, substance use, and their infants' behaviors. Structural equation modeling revealed that prenatal, but not postnatal, IPV was independently associated with infant cortisol reactivity and problem behavior. Maternal mental health predicted infant behavioral functioning but not infant HPA axis reactivity. These findings are consistent with the prenatal programming hypothesis; that is, early life stress affects later risk and vulnerability for altered physiological and behavioral regulation.
    Stress (Amsterdam, Netherlands) 10/2015; DOI:10.3109/10253890.2015.1108303 · 2.72 Impact Factor
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    • "The following possible confounders were examined: infant sex, infant age at center care entry, time since the last feeding with respect to cortisol sampling, time awake with respect to cortisol sampling, maternal age, and maternal educational level. Also, to control for maternal postpartum depression, mothers completed the Edinburgh Postnatal Depression Scale (EPDS, Cox et al., 1987) at 3 months postpartum. This 10-item questionnaire, scored on a 4-point scale, is widely used to measure depression. "
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    ABSTRACT: Cortisol concentrations of older children in childcare centers have been found to be higher than at home. This study focuses on infant cortisol in childcare centers throughout the first year of life, and aims to investigate whether inter-individual differences can be explained by temperament, the quality of maternal behavior, and the quality of center care. Sixty-four infants were followed for 9 months after entering care at 3 months of age. Salivary samples were taken at 10.00 h and 16.00 h in center care (in post-entry weeks 1, 2, 3, 4, 8, 12, 16, 24, and 36) and at home (in post-entry weeks 1, 24, and 36). Prior to entry, mothers completed a temperament questionnaire and the quality of maternal behavior (sensitivity and cooperation) was observed during routine bathing sessions. Subsequently, the infants were visited three times at center care to observe the quality of infant's interactive experiences with their professional caregiver. Longitudinal regression models showed that both morning and afternoon cortisol were higher in center care compared to home. Longitudinal regression models showed that infants receiving higher quality of maternal behavior displayed higher morning cortisol in center care, compared to infants receiving lower quality of maternal behavior. Higher quality of maternal behavior was also related to higher afternoon cortisol in center care, but only in infants high in negative emotionality. Center care quality was not related to cortisol. In sum, young infants show higher cortisol concentrations in center care that are related to infant temperament and quality of maternal behavior at home.
    Stress (Amsterdam, Netherlands) 10/2015; DOI:10.3109/10253890.2015.1089230 · 2.72 Impact Factor
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    • "The socio - demographic questionnaire was developed by the Authors of the study in order to assess the composition of the nuclear family , the educational background , the story of the couple ' s relationship and general information about the course of pregnancy and causes of premature delivery . The EPDS ( Cox et al . , 1987 ) is a self - report questionnaire composed of 10 items scored on a 4 - point Likert scale ( ranging from 0 " never " to 3 " always " ) designed to assess postpartum depression . The total score can range from 0 to 30 ."
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    ABSTRACT: Aim: The study explored fathers' experience of premature birth during the hospitalization of their infants, analyzing levels of depressive and anxiety symptoms as compared with mothers. Moreover the Italian version of the Clinical Interview for Parents of High-Risk Infant (CLIP) was tested through confirmatory factor analysis. Methods: Couples of parents (N = 64) of preterm infants (gestational age < 37 weeks) were administered a socio-demographic questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory and the CLIP after the admission to the Neonatal Intensive Care Unit (NICU). Results: Significant levels of anxiety and depressive symptoms and high percentages of subjects above the corresponding risk thresholds were found among fathers and mothers with higher scores among the latters. Confirmatory factor analysis of the CLIP showed an adequate structure, with better fit for mothers than for fathers. Conclusion: RESULTS highlighted the importance for nurses and clinicians working in the NICU to consider not only the maternal difficulties but also the paternal ones, even if these are often more hidden and silent. In addition the CLIP may be considered an useful interview for research and clinical purposes to be used with parents of high-risk infants.
    Frontiers in Psychology 09/2015; 6. DOI:10.3389/fpsyg.2015.01444 · 2.80 Impact Factor
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