Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS-Dep-5

Research output: Contribution to journalJournal articleResearchpeer-review

  • Daphna Harel
  • Brooke Levis
  • Miyabi Ishihara
  • Alexander W. Levis
  • Simone N. Vigod
  • Louise M. Howard
  • Brett D. Thombs
  • Andrea Benedetti
  • Ying Sun
  • Chen He
  • Ankur Krishnan
  • Yin Wu
  • Parash Mani Bhandari
  • Dipika Neupane
  • Zelalem Negeri
  • Mahrukh Imran
  • Danielle B. Rice
  • Marleine Azar
  • Matthew J. Chiovitti
  • Nazanin Saadat
  • Kira E. Riehm
  • Jill T. Boruff
  • Pim Cuijpers
  • Simon Gilbody
  • John P.A. Ioannidis
  • Lorie A. Kloda
  • Scott B. Patten
  • Ian Shrier
  • Roy C. Ziegelstein
  • Liane Comeau
  • Nicholas D. Mitchell
  • Marcello Tonelli
  • Jacqueline Barnes
  • Cheryl Tatano Beck
  • Carola Bindt
  • Felipe Pinheiro de Figueiredo
  • Gracia Fellmeth
  • Barbara Figueiredo
  • Eric P. Green
  • Nadine Helle
  • Pirjo A. Kettunen
  • Jane Kohlhoff
  • Zoltán Kozinszky
  • Angeliki A. Leonardou
  • Sandra Nakić Radoš
  • Tamsen J. Rochat
  • Smith-Nielsen, Johanne
  • Alan Stein
  • Robert C. Stewart
  • Væver, Mette Skovgaard
  • the DEPRESsion Screening Data (DEPRESSD) EPDS Collaboration

Aims: This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression screening in pregnancy and postpartum, based on objective criteria. Methods: Item responses from the 10-item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary screening accuracy studies that compared the EPDS to the Structured Clinical Interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of screening accuracy of the EPDS as compared to the SCID. Results: A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). Conclusion: The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.

Original languageEnglish
JournalActa Psychiatrica Scandinavica
Volume143
Issue number4
Pages (from-to)348-362
Number of pages15
ISSN0001-690X
DOIs
Publication statusPublished - 2021

Bibliographical note

Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

    Research areas

  • depression, optimal test assembly, patient-reported outcome, short form

ID: 318202717