Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS‐Dep‐5. (19th January 2021)

• Record Type: Journal Article
• Authors: Harel, Daphna; Levis, Brooke; Ishihara, Miyabi; Levis, Alexander W.; Vigod, Simone N.; Howard, Louise M.; Thombs, Brett D.; Benedetti, Andrea
• Other Names: Sun Ying investigator.; He Chen investigator.; Krishnan Ankur investigator.; Wu Yin investigator.; Bhandari Parash Mani investigator.; Neupane Dipika investigator.; Negeri Zelalem investigator.; Imran Mahrukh investigator.; Rice Danielle B. investigator.; Azar Marleine investigator.; Chiovitti Matthew J. investigator.; Saadat Nazanin investigator.; Riehm Kira E. investigator.; Boruff Jill T. investigator.; Cuijpers Pim investigator.; Gilbody Simon investigator.; Ioannidis John P. A. investigator.; Kloda Lorie A. investigator.; Patten Scott B. investigator.; Shrier Ian investigator.; Ziegelstein Roy C. investigator.; Comeau Liane investigator.; Mitchell Nicholas D. investigator.; Tonelli Marcello investigator.; Barnes Jacqueline investigator.; Beck Cheryl Tatano investigator.; Bindt Carola investigator.; de Figueiredo Felipe Pinheiro investigator.; Fellmeth Gracia investigator.; Figueiredo Barbara investigator.; Green Eric P. investigator.; Helle Nadine investigator.; Kettunen Pirjo A. investigator.; Kohlhoff Jane investigator.; Kozinszky Zoltán investigator.; Leonardou Angeliki A. investigator.; Nakić Radoš Sandra investigator.; Rochat Tamsen J. investigator.; Smith‐Nielsen Johanne investigator.; Stein Alan investigator.; Stewart Robert C. investigator.; Tadinac Meri investigator.; Tandon S. Darius investigator.; Tendais Iva investigator.; Töreki Annamária investigator.; Tran Thach D. investigator.; Turner Katherine investigator.; Væver Mette S. investigator.; Vega‐Dienstmaier Johann M. investigator.;
• Is Part Of: Acta psychiatrica Scandinavica. Volume 143:Number 4(2021)
• Page Start: 348
• Page End: 362
• Publication Date: 2021-01-19
• Subjects: depression -- optimal test assembly -- patient‐reported outcome -- short form; Psychiatry -- Periodicals; 616.89
• DOI: 10.1111/acps.13272
• Languages: English
• ISSNs: 0001-690X

Abstract

Abstract: 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.