A proposal for a new Brazilian six-item version of the Edinburgh Postnatal Depression Scale

Abstract

Introduction: Factor analysis of the Edinburgh Postnatal Depression Scale (EPDS) could result in a shorter and easier to handle screening tool. Therefore, the aim of this study was to check and compare the metrics of two different 6-item EPDS subscales. Methods: We administered the EPDS to a total of 3,891 women who had given birth between 1 and 3 months previously. We conducted confirmatory and exploratory factor analyses and plotted receiver-operating characteristics (ROC) curves to, respectively, determine construct validity, scale items' fit to the data, and ideal cutoff scores for the short versions. Results: A previously defined 6-item scale did not exhibit construct validity for our sample. Nevertheless, we used exploratory factor analysis to derive a new 6-item scale with very good construct validity. The area under the ROC curve of the new 6-item scale was 0.986 and the ideal cutoff score was ≥ 6. Conclusions: The new 6-item scale has adequate psychometric properties and similar ROC curve values to the10-item version and offers a means of reducing the cost and time taken to administer the instrument.

Development and validation of a three‐item version of the Edinburgh Postnatal Depression Scale

“…In the literature, factor analyses of the full version of the EPDS have led to the development of six‐ or seven‐item depression subscales (Albuquerque et al, 2017; Gollan et al, 2017; Phillips et al, 2009), and predictive models that have incorporated several sociodemographic and clinical variables (Jiménez‐Serrano, Tortajada, & García‐Gómez, 2015) or which evaluated the predictive power of biomarkers (Osborne et al, 2016) have been devised. The three‐item version of the EPDS reported in this study is at least twice as short and as accurate (or more accurate) as these alternatives, and, importantly, it seems to replicate the commonly found three‐factor solution (i.e., “anhedonia”: items 1 and 2; “anxiety”: items 3, 4, 5, and 6; and, “depression”: items 7, 8, 9, and 10) reported by other studies (Coates, Ayers, & de Visser, 2017).…”

“…Moreover, though previous efforts have been documented to reduce the full version of the EPDS (Albuquerque et al, 2017; Gollan et al, 2017; Kabir, Sheeder, & Kelly, 2008; Phillips, Charles, Sharpe, & Matthey, 2009), these studies have important limitations. For instance, Albuquerque et al (2017), Gollan et al (2017), and Kabir et al (2008) proposed six‐, seven‐, and two‐item versions of the EPDS, respectively, although evaluation of their performance lacked the use of a formal psychiatric diagnostic assessment to ascertain postpartum depression status. In addition, Phillips et al (2009), conducted testing of the seven‐item version of the EPDS in a highly selected sample of women and finding a substantial proportion of false positives.…”

The factor structure of the Edinburgh Postnatal Depression Scale among perinatal high-risk and community samples in London

“…CFA was conducted on the remaining 60% of the data using weighted least squares mean and variance (WLSMV), which uses polychoric correlations and robust corrections to account for ordinal and nonnormally distributed data (e.g. Lydsdottir et al 2019;Albuquerque et al 2017;Martin and Redshaw 2018). As much of the previous literature has used MLE, we also performed CFA using this method (results reported in Supplement).…”