Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis.
Journal: Canadian journal of psychiatry. Revue canadienne de psychiatrie
Volume: 65
Issue: 12
Year of Publication: 2021
Affiliated Institutions:
Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Women's College Hospital and Research Institute, University of Toronto, Ontario, Canada.
Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada.
Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, Vrije Universiteit Amsterdam, the Netherlands.
Department of Health Sciences, Hull York Medical School, University of York, Heslington, York, United Kingdom.
Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA.
Library, Concordia University, Montréal, Québec, Canada.
Departments of Community Health Sciences and Psychiatry, University of Calgary, Alberta, Canada.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada.
Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, University of Calgary, Alberta, Canada.
Department of Psychological Sciences, Birkbeck, University of London, United Kingdom.
University of Connecticut School of Nursing, Mansfield, CT, USA.
Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
School of Psychology, University of Minho, Portugal.
Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
School of Psychiatry, University of New South Wales, Kensington, Australia.
Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden.
First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Greece.
Department of Psychology, Catholic University of Croatia, Croatia.
Department of Obstetrics and Gynaecology, Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands.
MRC/Developmental Pathways to Health Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Division of Psychiatry, University of Edinburgh, Scotland.
Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia.
Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Emergency, University of Szeged, Hungary.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Epilepsy Cter-Child Neuropsychiatry Unit, ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy.
Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
Abstract summary
The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).We searched Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and the Web of Science Core Collection through June 2016 for studies with data sets with item response data to calculate EPDS-5 scores and that used the SCID to ascertain depression status. We conducted an individual participant data meta-analysis to estimate pooled percentage of EPDS-5 ≥7, pooled SCID major depression prevalence, and the pooled difference in prevalence.A total of 3,958 participants from 19 primary studies were included. Pooled prevalence of SCID major depression was 9.2% (95% confidence interval [CI] 6.0% to 13.7%), pooled percentage of participants with EPDS-5 ≥7 was 16.2% (95% CI 10.7% to 23.8%), and pooled difference was 8.0% (95% CI 2.9% to 13.2%). In the 19 included studies, mean and median ratios of EPDS-5 to SCID prevalence were 2.1 and 1.4 times.Prevalence estimated based on EPDS-5 ≥7 appears to be substantially higher than the prevalence of major depression. Validated diagnostic interviews should be used to establish prevalence.
Authors & Co-authors:
Thombs Brett D BD
Levis Brooke B
Lyubenova Anita A
Neupane Dipika D
Negeri Zelalem Z
Wu Yin Y
Sun Ying Y
He Chen C
Krishnan Ankur A
Vigod Simone N SN
Bhandari Parash Mani PM
Imran Mahrukh M
Rice Danielle B DB
Azar Marleine M
Chiovitti Matthew J MJ
Saadat Nazanin N
Riehm Kira E KE
Boruff Jill T JT
Cuijpers Pim P
Gilbody Simon S
Ioannidis John P A JPA
Kloda Lorie A LA
Patten Scott B SB
Shrier Ian I
Ziegelstein Roy C RC
Comeau Liane L
Mitchell Nicholas D ND
Tonelli Marcello M
Barnes Jacqueline J
Beck Cheryl Tatano CT
Bindt Carola C
Figueiredo Barbara B
Helle Nadine N
Howard Louise M LM
Kohlhoff Jane J
Kozinszky Zoltán Z
Leonardou Angeliki A AA
Radoš Sandra Nakić SN
Quispel Chantal C
Rochat Tamsen J TJ
Stein Alan A
Stewart Robert C RC
Tadinac Meri M
Tandon S Darius SD
Tendais Iva I
Töreki Annamária A
Tran Thach D TD
Trevillion Kylee K
Turner Katherine K
Vega-Dienstmaier Johann M JM
Benedetti Andrea A
Study Outcome
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