Comparative performance of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-9 in pregnant and postpartum women seeking psychiatric services

Abstract

Adoption of a standard depression measures across clinics and populations is advantageous for continuity of care and facilitation of research. This study provides information on the comparative utility of a commonly used perinatal-specific depression instrument (the Edinburgh Postnatal Depression Scale-EPDS) with a general depression screener (Patient Health Questionnaire-9-PHQ-9) in a sample of perinatal women seeking psychiatry services within a large health care system. Electronic medical records (which included PHQ-9 and EDPS) were abstracted for a final sample of 81 pregnant and 104 postpartum patients (n=185). Psychometric properties were examined among women who met the criteria for Major Depressive Disorder (MDD) based on clinician diagnoses, as compared to women without any mood disorder diagnosis. Using commonly recommended cut-off scores, both measures had comparable sensitivity, specificity, PPV and NPV for both pregnant and postpartum women. Comparative AUC for ROC contrasts were not significantly different between the two measures. Thus, this study found few significant differences in the performance of the PHQ-9 and EPDS in detecting clinician-diagnosed MDD in a psychiatry outpatient sample of pregnant and postpartum women.