Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta‐analysis
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Objectives: Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. Methods: We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random‐effects meta‐analysis was used to compare prevalence with EPDS cutoffs versus the SCID. Results: Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%–34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%–11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%–12.3%). EPDS ≥14 provided pooled prevalence closest to SCID‐based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: −13.7%, 12.3%). Conclusion: EPDS ≥14 approximated SCID‐based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.
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The EPDS has excellent overall test characteristics for the identification of depression, with results comparable to a structured clinical interview for DSM-5 major depression diagnosis.
“The EPDS has excellent overall test characteristics for the identification of depression, with results comparable to a structured clinical interview for DSM‐5 major depression diagnosis [34].”
From Factors associated with postpartum depression symptoms following antepartum hospitalization (2026) · cites this paper as [34]
The Results report that an EPDS cutoff of ≥14 produced an overall prevalence estimate close to the SCID estimate. But the Discussion says the study did not evaluate how accurately the EPDS identifies individuals with depression, and that EPDS-based prevalence can differ substantially from SCID-based prevalence in individual studies. It therefore does not establish excellent test characteristics or general comparability to a diagnostic interview. (LLM, conf=0.86)
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- Authors
- Lyubenova, A., Neupane, D., Levis, B., Wu, Y., Sun, Y., He, C., Krishnan, A., Bhandari, P. M., Negeri, Z., Imran, M., Rice, D. B., Azar, M., Chiovitti, M. J., Saadat, N., Riehm, K. E., Boruff, J. T., Ioannidis, J. P. A., Cuijpers, P., Gilbody, S., Kloda, L. A., Patten, S. B., Shrier, I., Ziegelstein, R. C., Comeau, L., Mitchell, N. D., Tonelli, M., Vigod, S. N., Aceti, F., Barnes, J., Bavle, A. D., Beck, C. T., Bindt, C., Boyce, P. M., Bunevicius, A., Chaudron, L. H., Favez, N., Figueiredo, B., Garcia‐Esteve, L., Giardinelli, L., Helle, N., Howard, L. M., Kohlhoff, J., Kusminskas, L., Kozinszky, Z., Lelli, L., Leonardou, A. A., Meuti, V., Radoš, S. N., García, P. N., Pawlby, S. J., Quispel, C., Robertson‐Blackmore, E., Rochat, T. J., Sharp, D. J., Siu, B. W. M., Stein, A., Stewart, R. C., Tadinac, M., Tandon, S. D., Tendais, I., Töreki, A., Torres‐Giménez, A., Tran, T. D., Trevillion, K., Turner, K., Vega‐Dienstmaier, J. M., Benedetti, A., & Thombs, B. D.
- Affiliations
- Jewish General Hospital (CA)
- Johns Hopkins University (US)
- McGill University (CA)
- Stanford Medicine (US)
- Amsterdam Public Health (NL)
- University of York (GB)
- Concordia University (CA)
- University of Calgary (CA)
- Université de Montréal (CA)
- Alberta Health Services (CA)
- University of Toronto (CA)
- Sapienza University of Rome (IT)
- University of London (GB)
- Rajarajeswari Medical College and Hospital (IN)
- University of Connecticut (US)
- University Medical Center Hamburg-Eppendorf (DE)
- The University of Sydney (AU)
- Neuroscience Institute Lithuanian University of Health Sciences Kaunas Lithuania
- University of Rochester Medicine (US)
- University of Geneva (CH)
- School of Psychology University of Minho Braga Portugal
- Perinatal Mental Health Unit CLINIC‐BCN Institut Clínic de Neurociències Hospital Clínic Barcelona Spain
- University of Florence (IT)
- King's College London (GB)
- UNSW Sydney (AU)
- Private Practice Hamburg Germany
- Danderyds sjukhus (SE)
- National and Kapodistrian University of Athens (GR)
- Catholic University of Croatia (HR)
- Albert Schweitzer Ziekenhuis (NL)
- Halifax Health Medical Center (US)
- Human Sciences Research Council (ZA)
- University of Bristol (GB)
- Castle Peak Hospital (CN)
- University of the Witwatersrand (ZA)
- Malawi Epidemiology and Intervention Research Unit (MW)
- University of Zagreb (HR)
- Northwestern University (US)
- University of Minho (PT)
- University of Szeged (HU)
- Monash University (AU)
- Ospedale San Paolo (IT)
- Universidad Peruana Cayetano Heredia (PE)
- McGill University Health Centre (CA)
- Corresponding author
- Benedetti, Andrea
- Thombs, Brett D.
- ORCID
- Levis, Brooke
- Wu, Yin
- Sun, Ying
- He, Chen
- Krishnan, Ankur
- Bhandari, Parash M.
- Negeri, Zelalem
- Imran, Mahrukh
- Rice, Danielle B.
- Riehm, Kira E.
- Boruff, Jill T.
- Ioannidis, John P. A.
- Cuijpers, Pim
- Gilbody, Simon
- Kloda, Lorie A.
- Patten, Scott B.
- Shrier, Ian
- Ziegelstein, Roy C.
- Tonelli, Marcello
- Vigod, Simone N.
- Aceti, Franca
- Barnes, Jacqueline
- Beck, Cheryl T.
- Bindt, Carola
- Boyce, Philip M.
- Favez, Nicolas
- Howard, Louise M.
- Kohlhoff, Jane
- Kozinszky, Zoltán
- Meuti, Valentina
- Radoš, Sandra N.
- Pawlby, Susan J.
- Quispel, Chantal
- Rochat, Tamsen J.
- Siu, Bonnie W. M.
- Stein, Alan
- Stewart, Robert C.
- Tadinac, Meri
- Tandon, S. Darius
- Tendais, Iva
- Töreki, Annamária
- Tran, Thach D.
- Trevillion, Kylee
- Turner, Katherine
- Vega‐Dienstmaier, Johann M.
- Benedetti, Andrea
- Thombs, Brett D.
- Venue
- International Journal of Methods in Psychiatric Research
- Publisher
- Wiley
- Published
- 2020-10-22
- Volume
- 30
- Issue
- 1
- Pages
- e1860-e1860
- ISSN
- 1049-8931 (ISSN-L)
- 1557-0657
- PMC
- PMC7992289
- OpenAlex
- W3094506883
- Cited by
- 63
- References
- 48
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 7 · 2023: 18 · 2022: 7 · 2021: 6 · 2020: 1
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Methods in Psychiatric Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, cc-by)
- Universidad Peruana Cayetano Heredia Institutional Repository (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- SERVAL (Université de Lausanne) (publishedVersion, cc-by)
- SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion, other-oa)
- IRIS (submittedVersion, cc-by)
- eScholarship@McGill (McGill) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Lithuanian University of Health Sciences (submittedVersion, cc-by)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc-nd)
- Explore Bristol Research (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Greater South Information System
- Funders
- Canadian Institutes of Health Research (KRS‐140994)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- postpartum depression, antenatal depression, Edinburgh Postnatal Depression Scale, depression prevalence, diagnostic agreement, screening validity, individual patient data
- MeSH terms
- Depression, Major Depressive Disorder, Female, Humans, Pregnancy, Psychiatric Status Rating Scales, Prevalence, Depression, Postpartum
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