Cited by 153Maternal Mental Health During Pregnancy and PostpartumAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMaternal and Neonatal Healthcare

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Screening for perinatal depression with the Patient Health Questionnaire depression scale (PHQ-9): A systematic review and meta-analysis

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Wang, Larry, Kroenke, Kurt, Stump, Timothy E., Monahan, Patrick O.·2021·General Hospital Psychiatry

DOI 10.1016/j.genhosppsych.2020.12.007PMC PMC9112666

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Abstract

Objectives Perinatal depression (PND) is a prevalent and disabling problem both during pregnancy and the postpartum period. The legacy screening measure has been the Edinburgh Postnatal Depression Scale (EPDS). This systematic review examines the validity of the PHQ-9 as a screener for PND.Methods The following databases were searched from January 2001 (when the PHQ-9 was first published) through June 2020: MEDLINE, Embase, and PsychInfo. Studies that compared the PHQ-9 to a criterion standard psychiatric interview were used to determine the operating characteristics of sensitivity, specificity and area under the curve (AUC). Studies comparing the PHQ-9 to the EPDS and other depression scales evaluated convergent validity.Results A total of 35 articles were eligible for criterion (n = 10) or convergent (n = 25) validity. Meta-analysis of the 7 criterion validity studies using the standard PHQ-9 cut point ≥10 showed a pooled sensitivity, specificity and AUC of 0.84, 0.81 and 0.89, respectively. Operating characteristics of the PHQ-9 and EPDS were nearly identical in head-to-head comparison studies. The median correlation between the PHQ-9 and EPDS was 0.59, and categorical agreement was moderate.Conclusions The PHQ-9 appears to be a viable option for perinatal depression screening with operating characteristics similar to the legacy EPDS.

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Authors: Wang, L., Kroenke, K., Stump, T. E., & Monahan, P. O.
Affiliations: Indiana University School of Medicine (US)
Regenstrief Institute (US)
Indiana University Indianapolis (US)
Corresponding author: Kroenke, Kurt
ORCID: Wang, Larry
Kroenke, Kurt
Stump, Timothy E.
Monahan, Patrick O.
Venue: General Hospital Psychiatry
Publisher: Elsevier BV
Published: 2021-01
Volume: 68
Pages: 74-82
ISSN: 0163-8343 (ISSN-L)
DOI: 10.1016/j.genhosppsych.2020.12.007
PMC: PMC9112666
OpenAlex: W3115587826
Cited by: 153
References: 101
Citations by year: 2026: 37 · 2025: 39 · 2024: 29 · 2023: 27 · 2022: 14 · 2021: 7
FWCI: 2.00
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: General Hospital Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
IUScholarWorks (Indiana University) (submittedVersion)
Purdue University Indianapolis (Indiana University) (submittedVersion)
Funders: National Center for Advancing Translational Sciences (UL1TR002529)
Indiana Clinical and Translational Sciences Institute
National Institutes of Health
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 › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: perinatal depression, PHQ-9, Edinburgh Postnatal Depression Scale, depression screening, screening validity, sensitivity and specificity, convergent validity, postpartum depression, pregnancy
MeSH terms: Patient Health Questionnaire, Depression, Female, Humans, Mass Screening, Pregnancy, Psychiatric Status Rating Scales, Sensitivity and Specificity, Depression, Postpartum

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Screening for perinatal depression with the Patient Health Questionnaire depression scale (PHQ-9): A systematic review and meta-analysis

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