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- Title
Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis.
- Authors
Thombs, Brett D.; Levis, Brooke; Lyubenova, Anita; Neupane, Dipika; Negeri, Zelalem; Wu, Yin; Sun, Ying; He, Chen; Krishnan, Ankur; Vigod, Simone N.; Bhandari, Parash Mani; Imran, Mahrukh; Rice, Danielle B.; Azar, Marleine; Chiovitti, Matthew J.; Saadat, Nazanin; Riehm, Kira E.; Boruff, Jill T.; Cuijpers, Pim; Gilbody, Simon
- Abstract
<bold>Objective: </bold>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).<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
POSTPARTUM depression; META-analysis; EPIDEMIOLOGY; PSYCHIATRY; EVIDENCE-based medicine
- Publication
Canadian Journal of Psychiatry, 2020, Vol 65, Issue 12, p835
- ISSN
0706-7437
- Publication type
journal article
- DOI
10.1177/0706743720934959