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Simple questionnaire useful screening tool for postpartum depression

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – A condensed version of the 10-item Edinburgh Postpartum Depression Scale (EPDS) is useful in screening for postpartum depression in primary care settings, according to a report in the September issue of Pediatrics.

Dr. Karolyn Kabir, from the University of Colorado Denver, and colleagues examined three subscales of the 10-item EPDS as ultrabrief alternatives to screening with the full test. The EPDS-3 included three questions focusing on anxiety, EPDS-7 featured seven focusing on depression, EPDS-2 included two resembling those found in the Patient Health Questionnaire.

The study included 41 mothers, between 14 and 26 years of age, who were referred for assessment of possible postpartum depression. The screening performance of the EPDS-2, EPDS-3, and EPDS-7 were compared to that of the full 10-item EPDS.

The EPDS-3 performed the best as a screening tool with a sensitivity of 95% and a negative predictive value of 98%. Compared with the full test, the EPDS-3 identified 16% more subjects as being depressed.

For the EPDS-3, women are asked to respond to these statements: –I have blamed myself unnecessarily when things went wrong; –I have felt scared or panicky for not very good reason; –I have been anxious or worried for no good reason.

The EPDS-2 had the worst performance with a raw score sensitivity and negative predictive value of 48% and 88%, respectively. This test was also unreliable for mothers without a history of depression. EPDS-7 had a sensitivity of 59% and a negative predictive value of 90%.

“Our findings strongly suggest that healthcare providers who do not have time to administer the full EPDS should consider incorporating the EPDS-3 into their health maintenance visits with new mothers,” Dr. Kabir’s team concludes.

Pediatrics 2008;122:e696-e702.