The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women
Alberto Stefana, Fiorino Mirabella, Antonella Gigantesco, Laura Camoni, for the Perinatal Mental Health Nework, Franca Aceti, Ilaria Adulti, Lucia Aite, Pietro Bagolan, Gina Barbano, Antonello Bellomo, Silvia Bucci, Simona Cappelletti, Marina Cattaneo, Elda Cengia, Rodica Cojoca, Giuseppe Cuccì, Loredana Desimone, Monica Del Sole, Angela Fabiano, Chiara Falamesca, Laura Favretti, Alice Fent, Laura Ferraro, Nicoletta Giacchetti, Antonella Grillo, Teresa Grimaldi Capitello, Daniele La Barbera, Marianna Mazza, Loredana Messina, Cinzia Niolu, Giovanna Picciano, Maria Pistillo, Laura Raho, Miryam Regonesi, Rossana Riolo, Ângela Garcia Rossi, Gabriele Sani, Martina Smorti, Damiana Tomasello, Antonella Triggiani
Abstract
BACKGROUND: This study aims to examine whether the Edinburgh Postnatal Depression Scale (EPDS), excluding the self-harm item (EPDS-9), performs as effectively as the full EPDS in identifying depression among perinatal women. METHODS: A total of 3571 pregnant women and 3850 postpartum women participated in this observational study. Participants who scored ≥ 9 on the EPDS underwent further diagnostic evaluations by a clinical psychologist and/or psychiatrist. RESULTS: = 0.998) cohorts. EPDS-9 showed exceptional precision in identifying depression as screened by the full EPDS at cutoff points ranging 9-14, with areas under the curve ≥0.998. The sensitivity of EPDS-9 and full EPDS to detect depression that requires psychotropic medications was poor. The highest accuracy for both versions was at a cutoff score of 9: sensitivity of 0.579 for the full EPDS and 0.526 for the EPDS-9. At the cutoff point of 9, EPDS-9 performed adequately in predicting the response of the participants to the self-harm item. CONCLUSION: The EPDS-9 represents a solid and effective replacement for the full EPDS in clinical settings. If the presence of suicidal thoughts needs to be assessed, specialized scales should be used.