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J Affect Disord. 2014 Jun;162:1-7. doi: 10.1016/j.jad.2014.03.028. Epub 2014 Mar 26.

Comparative performance of Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale for screening antepartum depression.

Author information

1
Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, K505F, Boston, MA 02115, United States.
2
Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, K505F, Boston, MA 02115, United States. Electronic address: bgelaye@hsph.harvard.edu.
3
Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru.
4
Universidad San Martin de Porres, Lima, Peru.
5
Asociación Civil PROESA, Lima, Peru.
6
Group Health Research Institute, Seattle, WA, United States.
7
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
8
School of Medicine, Perdana University, Kuala Lumpur, Malaysia.

Abstract

OBJECTIVE:

We sought to evaluate the psychometric properties of two widely used screening scales: the Patient Health Questionnaire (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) among pregnant Peruvian women.

METHODS:

This cross-sectional study included 1517 women receiving prenatal care from February 2012 to March 2013. A structured interview was used to collect data using PHQ-9 and EPDS. We examined reliability, construct and concurrent validity between two scales using internal consistency indices, factor structures, correlations, and Cohen׳s kappa.

RESULTS:

Both scales had good internal consistency (Cronbach׳s alpha>0.8). Correlation between PHQ-9 and EPDS scores was fair (rho=0.52). Based on exploratory factor analysis (EFA), both scales yielded a two-factor structure. EFA including all items from PHQ-9 and EPDS yielded four factors, namely, "somatization", "depression and suicidal ideation", "anxiety and depression", and "anhedonia". The agreement between the two scales was generally fair at different cutoff scores with the highest Cohen׳s kappa being 0.46.

CONCLUSIONS:

Both the PHQ-9 and EPDS are reliable and valid scales for antepartum depression assessment. The PHQ-9 captures somatic symptoms, while EPDS detects depressive symptoms comorbid with anxiety during early pregnancy. Our findings suggest simultaneous administration of both scales may improve identification of antepartum depressive disorders in clinical settings.

KEYWORDS:

Antepartum depression; EPDS; PHQ-9; Peru

PMID:
24766996
PMCID:
PMC4040145
DOI:
10.1016/j.jad.2014.03.028
[Indexed for MEDLINE]
Free PMC Article
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