Subscales measuring symptoms of non‐specific depression, anhedonia, and anxiety in the Edinburgh Postnatal Depression Scale

Abstract

It was concluded that there is now sufficient evidence that clinicians should not assume the EPDS to be unidimensional, but should assess all three subscales when screening for susceptibility to post-partum depression and/or post-partum anxiety.

Replicability of structural models of the Edinburgh Postnatal Depression Scale (EPDS) in a community sample of postpartum African American women with low socioeconomic status

“…Criteria for model selection include previous evaluation with the English language version of the EPDS or advancement in the literature as a good-fitting model in a postpartum sample. The models evaluated included the: (1) original unidimensional model of Cox et al (1987), (2) twofactor (depression, anxiety) model of Phillips et al (2009), (3) the three-factor (anhedonia, anxiety, and depression) model of Tuohy and McVey (2008), (4) a two-factor (depression, anxiety) version of the Brouwers et al (2001) model, and (5) a two-factor version of the Ross et al (2003) model. Two models (Brouwers et al 2001;Ross et al 2003) were originally three-factor models, both with only item 10 loading on a third factor.…”

“…Of published principal components analysis (PCA) and exploratory factor analysis (EFA) reported in English in both postpartum and prenatal samples, only Berle et al (2003) confirmed a unidimensional structure of the EPDS using a Norwegian sample. The vast majority of the literature suggests that the EPDS may represent factors in addition to depression, including anxiety (Adouard et al 2005;Astbury et al 1994;Matthey 2008;Phillips et al 2009;Pop et al 1992), anxiety and anhedonia (Chabrol and Teissedre 2004;Montazeri et al 2007;Tuohy and McVey 2008), or anxiety and suicide (Brouwers et al 2001;Jomeen and Martin 2005;Ross et al 2003;Tuohy and McVey 2008). Guedeney and Fermanian (1998) also identified two factors but conceptualized them as depressive symptoms (which included items commonly associated with the anxiety factor in other studies) and depressive mood.…”

“…The anhedonia component or factor consistently included items 1 and 2, with or without other items. Tuohy and McVey (2008) found that the HADS-A and PANAS-N were associated with higher scores on the anhedonia factor (items 1 and 2), while the PANASpositive affect subscale was associated with lower scores. While these studies provide support for the concurrent validity of the anxiety and anhedonia subscales as defined, the variable structure and indicator loadings across studies raise question to the stability of the EPDS across contexts and populations, as well as its validity as a measure of perinatal depression.…”

“…Brouwers et al (2001) found that the anxiety component in their study (items 3, 4, and 5) correlated (r00.73) with the state-trait anxiety inventory (STAI) with women at 24 weeks gestation. Tuohy and McVey (2008) found the HADS-A and the positive and negative affect scales-negative affect subscale (PANAS-N) were associated with higher scores on the anxiety factor (items 3, 4, and 5) in the postpartum. However, Ross et al (2003) found that the proportion of the anxiety component (items 3, 4, and 5) score in the EPDS total score was higher in late pregnancy than postpartum, challenging the stability of this relationship.…”

Reproductive Steroid Regulation of Mood and Behavior

“…Dysregulated affect in reproductive mood disorders includes increased negative affect (i.e., irritability, anger, sadness, and anxiety), decreased positive affect (i.e., anhedonia), and affective lability (233,329), while functional impairment is defined by clinically significant distress or disability in social, occupational, or other important activities (6). Reproductive mood disorders include PMDD, PPD, and perimenopausal depression.…”