TY - JOUR
T1 - Shortening the Edinburgh postnatal depression scale using optimal test assembly methods
T2 - Development of the EPDS-Dep-5
AU - the DEPRESsion Screening Data (DEPRESSD) EPDS Collaboration
AU - Harel, Daphna
AU - Levis, Brooke
AU - Ishihara, Miyabi
AU - Levis, Alexander W.
AU - Vigod, Simone N.
AU - Howard, Louise M.
AU - Thombs, Brett D.
AU - Benedetti, Andrea
AU - Sun, Ying
AU - He, Chen
AU - Krishnan, Ankur
AU - Wu, Yin
AU - Bhandari, Parash Mani
AU - Neupane, Dipika
AU - Negeri, Zelalem
AU - Imran, Mahrukh
AU - Rice, Danielle B.
AU - Azar, Marleine
AU - Chiovitti, Matthew J.
AU - Saadat, Nazanin
AU - Riehm, Kira E.
AU - Boruff, Jill T.
AU - Cuijpers, Pim
AU - Gilbody, Simon
AU - Ioannidis, John P.A.
AU - Kloda, Lorie A.
AU - Patten, Scott B.
AU - Shrier, Ian
AU - Ziegelstein, Roy C.
AU - Comeau, Liane
AU - Mitchell, Nicholas D.
AU - Tonelli, Marcello
AU - Barnes, Jacqueline
AU - Beck, Cheryl Tatano
AU - Bindt, Carola
AU - de Figueiredo, Felipe Pinheiro
AU - Fellmeth, Gracia
AU - Figueiredo, Barbara
AU - Green, Eric P.
AU - Helle, Nadine
AU - Kettunen, Pirjo A.
AU - Kohlhoff, Jane
AU - Kozinszky, Zoltán
AU - Leonardou, Angeliki A.
AU - Nakić Radoš, Sandra
AU - Rochat, Tamsen J.
AU - Smith-Nielsen, Johanne
AU - Stein, Alan
AU - Stewart, Robert C.
AU - Tadinac, Meri
N1 - Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2021/4
Y1 - 2021/4
N2 - Aims: This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression screening in pregnancy and postpartum, based on objective criteria. Methods: Item responses from the 10-item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary screening accuracy studies that compared the EPDS to the Structured Clinical Interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of screening accuracy of the EPDS as compared to the SCID. Results: A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). Conclusion: The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
AB - Aims: This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression screening in pregnancy and postpartum, based on objective criteria. Methods: Item responses from the 10-item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary screening accuracy studies that compared the EPDS to the Structured Clinical Interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of screening accuracy of the EPDS as compared to the SCID. Results: A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). Conclusion: The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
KW - depression
KW - optimal test assembly
KW - patient-reported outcome
KW - short form
KW - Pregnancy
KW - Psychiatric Status Rating Scales
KW - Reproducibility of Results
KW - Depression, Postpartum/diagnosis
KW - Humans
KW - Sensitivity and Specificity
KW - Depressive Disorder, Major
KW - Female
UR - http://www.scopus.com/inward/record.url?scp=85100183078&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100183078&partnerID=8YFLogxK
U2 - 10.1111/acps.13272
DO - 10.1111/acps.13272
M3 - Article
C2 - 33354768
AN - SCOPUS:85100183078
SN - 0001-690X
VL - 143
SP - 348
EP - 362
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
IS - 4
ER -