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

National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 06/2009; 119(5):350-64. DOI: 10.1111/j.1600-0447.2009.01363.x
Source: PubMed


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.
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.
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.
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.

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Available from: Kirstie McKenzie-McHarg, Jan 10, 2014
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    • "Although designed for postnatal women it is commonly used and is well validated for use in pregnant women to screen for depression (Gibson et al., 2009). The EPDS is validated for use as a continuous measure of depressive symptoms (Gibson et al., 2009) with an acceptable Chronbach's alpha of .80 (Brouwers et al., 2001b). Possible total scores range from 0 to 30. "
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    • "Our results indicated that cutoffs Z11 for the EPDS, Z15 for the BDI and Z9 for the HAM-D would be the optimal values for determining whether an individual should be referred to a professional for diagnostic confirmation. Differences in the prevalence, methodology, language, culture, diagnostic interviews and decision-making criteria used across study samples could be responsible for the variability in recommended cut-off scores (Halbreich and Karkun, 2006; Gibson et al., 2009). Our results may apply only to the second trimester of pregnancy in Brazil and must be interpreted in consideration of certain limitations. "
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    • "The shorter EPDS-3, although not a measure of depression severity, is considered a reliable screening tool to detect depression (Kabir et al. 2008). The EPDS is available in many languages (Gibson et al. 2009). The SPS has been used with mothers (Letourneau et al. 2011) and has strong validity and reliability (Cultrona & Russell 1987). "
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