Screening for antenatal depression with the Edinburgh Depression Scale

Abstract

This study aimed to evaluate how precise the Edinburgh Depression Scale (EDS) is in screening for major depressive disorder (MDD) during different periods of pregnancy. A random sample of 230 pregnant women was interviewed in the first, second, and third trimesters of pregnancy using the EDS and not-patient version of the Structured Clinical Interview for DSM-III-R (SCID-NP). We evaluated test-retest reliability of the EDS; area under the ROC curve (AUC), sensitivity, specificity, and positive predictive value (PPV) of the EDS against the SCID-NP diagnoses in the first, second, and third trimesters of pregnancy. Test-retest reliability of the EDS was 0.81 (p < 0.001). An optimal cutoff score of the EDS for screening current SCID-NP diagnosis of MDD was 12 and higher in the first trimester of pregnancy (AUC 0.94, sensitivity 92%, specificity 95%, and PPV 52%) and 11 and higher in the second and third trimesters of pregnancy (AUC 0.96 and 0.90, respectively; sensitivity 100% and 88%, respectively; specificity 92% and 92%, respectively; PPV 25% and 29%, respectively). The EPDS is a reliable instrument for repeated evaluations of depressive symptoms during pregnancy. It has a good sensitivity and specificity for detecting antenatal MDD with optimal cutoff of 11/12 or higher.