Validation of the Edinburgh Postnatal Depression Scale (EPDS) in a sample of mothers from the 2004 Pelotas Birth Cohort Study
Validation of the Edinburgh Postnatal Depression Scale (EPDS) in a sample of mothers from the 2004 Pelotas Birth Cohort Study
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DOI：
10.1590/s0102-311x2007001100005
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发表时间：
2007-11-01
期刊：
影响因子：
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通讯作者：
Barros, Fernando C.
中科院分区：
文献类型：
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作者：
Santos, Iná S.;Matijasevich, Alicia;Barros, Fernando C.
本研究的目的是评价爱丁堡产后抑郁量表(EPDS)对产后抑郁症的筛查和诊断价值。分娩三个月后，来自巴西南里奥格兰德州2004年Pelotas出生队列研究的378名母亲接受了EPDS治疗。直到15天后，心理健康护理专业人员使用基于ICD-10(黄金标准)的半结构化访谈对母亲们进行了重新访谈。我们计算每个临界点的灵敏度和特异度，并将其绘制为受试者操作员特征曲线。筛选产后抑郁症的最佳临界点为>；=10，灵敏度为82.6%(75.3-89.9%)，特异度为65.4%(59.8-71.1%)。筛选中、重度病例的最佳界值为>；=11，灵敏度为83.8%(73.4-91.3%)，特异度为74.7%(69.4-79.5%)。对于诊断，EPDS仅对产后抑郁的患病率在20%-25%范围内有效，60%PPV=13个临界点(59.5%的敏感度；88.4%的特异度)。所有截断点的特异性和PPV都低于其他作者报道的结果。在大多数研究中，病例代表性过高的样本中的PPV的计算似乎解释了这些差异。
The aim of this study was to evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening and diagnosis of postpartum depression. Three months after delivery, EPDS was administered to 378 mothers from the 2004 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil. Up to 15 days later, mothers were re-interviewed by mental health care professionals using a semi-structured interview based on ICD-10 (gold standard). We calculated the sensitivity and specificity of each cutoff point, and values were plotted as a receiver operator characteristic curve. The best cutoff point for screening postpartum depression was >= 10, with 82.6% (75.3-89.9%) sensitivity and 65.4% (59.8-71.1%) specificity. For screening moderate and severe cases, the best cutoff point was >= 11, with 83.8% (73.4-91.3%) sensitivity and 74.7% (69.4-79.5%) specificity. For diagnosis, EPDS was valid only for prevalence of postpartum depression in the 20-25% range, with 60% PPV for the >= 13 cutoff point (59.5% sensitivity; 88.4% specificity). The specificities and PPVs for all cutoff points were below those reported by other authors. Small numbers and the calculation of PPV in samples with overrepresentation of cases in the majority of studies appear to account for these differences.