Table 7Summary of validation studies of EPDS as a detection tool for depression in the postnatal period

StudySensitivitySpecificityPositive predictive valueNegative predictive valueNo. of women/countryType of sampleTime of presentation administrationMethod of presentation
EPDS cut-off/ comparator12/139/1012/139/1012/139/1012/139/10
Beck & Gable 2001bClinical interview (SCID-IV)7859998693649682150
USA
Recruited by media advertisement and through antenatal classes4–8 weeks postnatally approximatelyResearch nurse, psychotherapist, not clear if in clinic or at home
Boyce et al., 1993Clinical interview (Diagnostic Interview Schedule)10010095895047n/an/a103 (not clear if any of those requested to participate refused) AustraliaMixed; recruited from postnatal clinic and women referred to hospital with depression postnatally2–29 weeks postnatallyPsychologist in woman’s home
Cox et al., 1987Clinical interview (RDC criteria)869478517358n/an/a84 (not clear if any of those requested to participate refused) ScotlandIdentified by health visitors as high risk at 6 weeks postnatally3 months postnatallyResearcher in woman’s home
Harris et al., 1989Clinical interview95n/a93n/a75n/an/an/a126 (not clear if any of those requested to participate refused) WalesRecruited from antenatal booking clinic6–8 weeks postnatallyResearch psychiatrist at clinic
Leverton & Elliott, 2000Clinical interview (taken data for Catego)709093843323n/an/a199 (selected women eligible for prevention trial) EnglandAttendees at antenatal clinic3 months postnatallyResearch psychiatrist in woman’s home
Matthey et al., 2001Clinical interview3854958456398990230 (not clear if any of those requested to participate refused) AustraliaWomen participating with their partners in a fee-paid parenthood class6–9 weeks postnatallyResearcher in the woman’s home
Murray & Carothers, 1990Clinical interview (RDC criteria)688996826739n/an/a646
England
Community – recruited from postnatal wards6 weeks postnatallyResearch (study of infant development); administered by post
Zelkowitz & Milet, 1995SCID-III679194769178n/an/a1,559/2,087
Canada
Community6 weeks postnatallyBy telephone

NB Only validation studies where the specific prediction or detection tool was completed against a standardised diagnostic interview were included. Further, the validation was of the English-language version of the EPDS and sufficient data reported

n/a = not available

Sensitivity – proportion of those with depression who test positive; specificity – proportion of those without depression who test negative; positive predictive value – those correctly identified as having depression as a proportion of all positive test results; negative predictive value – those correctly identified as not having depression as proportion of all negative test results

From: 5, THE PREDICTION AND DETECTION OF MENTAL ILLNESS DURING PREGNANCY AND THE POSTNATAL PERIOD

Cover of Antenatal and Postnatal Mental Health
Antenatal and Postnatal Mental Health: The NICE Guideline on Clinical Management and Service Guidance.
NICE Clinical Guidelines, No. 45.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2007.
Copyright © 2007, The British Psychological Society & The Royal College of Psychiatrists.

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