Måleegenskaper ved den norske versjonen av Edinburgh Postnatal Depression Scale (EPDS)

Authors

  • Ketil Hanssen-Bauer Regionsenter for barn og unges psykiske helse Øst og Sør https://orcid.org/0000-0001-8303-2961
  • Audun Welander-Vatn Regionsenter for barn og unges psykiske helse Øst og Sør

DOI:

https://doi.org/10.21337/0017

Keywords:

Depresjon, Spedbarn, Voksne

Abstract

Description: John Cox et al. developed and published the Edinburgh Postnatal Depression Scale (EPDS) in 1987. The Royal College of Psychiatrists (UK) has the copyright for EPDS. There are two Norwegian translations. The copyright holder has only approved the 2001 translation by Malin Eberhard-Gran. This translation procedure involved back translation and comparison with the English original version. The EPDS measures depressive symptoms in postnatal women. It is a self-rating scale which consists of ten questions and takes five minutes to score. Trained health personnel are qualified to use the scale.

Literature search: We included 13 papers from 11 Norwegian studies, and four papers from four Swedish studies. We found no papers from Danish studies. Nine Norwegian papers reported EPDS mean scores and standard deviations for pregnant and/or postnatal women, one of which also reported these parameters for women neither pregnant nor postnatal.

Psychometrics: The evidence for criterion validity is weak, because it is investigated in only one study (n = 310), and the psychometric properties of the reference standard (PRIME-MD) is unknown. The study showed that using an EPDS score ≥ 10 as a cut-off gave no false negatives. However, given a three per cent prevalence of major depression, the proportion of false positives is very high (81 %). EPDS has good construct validity, based on large correlation coefficients with the MADRS (r = 0.78) and the SCL-25 (r = 0.80). These properties were investigated in the same study (N = 310). Good internal consistency reliability (Chronbach’s α) was found in five studies: α mean = 0.83 (range 0.81–0.86). The sample sizes varied from 310 to 2816 (mean 1697) participants in psychometric studies. Good test-retest reliability was found in one study: r = 0.74; N = 310.

Conclusion: The Norwegian version of the EPDS has good reliability, but validity is only investigated in one study that found weak diagnostic accuracy. There is a need for more studies on criterion validity comparing the Norwegian version of EPDS with the best possible diagnosis of depression.

References

Alvik, A., Torgersen, A. M., Aalen, O. O., & Lindemann, R. (2011). Binge alcohol exposure once a week in early pregnancy predicts temperament and sleeping problems in the infant. Early Human Development, 87(12), 827-833. http://dx.doi.org/10.1016/j.earlhumdev.2011.06.009

Bagedahl-Strindlund, M., & Börjesson, K. M. (1998). Postnatal depression: A hidden illness. Acta Psychiatrica Scandinavica, 98(4), 272-275. https://doi.org/10.1111/j.1600-0447.1998.tb10083.x

Berle, J., Aarre, T., Mykletun, A., Dahl, A., & Holsten, F. (2003). Screening for postnatal depression: Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. Journal of Affective Disorders, 76(1-3), 151-156. http://dx.doi.org/10.1016/S0165-0327%2802%2900082-4

Bjerke, S. E. Y., Vangen, S., Nordhagen, R., Ytterdahl, T., Magnus, P., & Stray-Pedersen, B. (2008). Postpartum depression among Pakistani women in Norway: prevalence and risk factors. Journal of Maternal-Fetal & Neonatal Medicine, 21(12), 889-894. https://doi.org/10.1080/14767050802320340

Cohen, M. M., Schei, B., Ansara, D., Gallop, R., Stuckless, N., & Stewart, D. E. (2002). A history of personal violence and postpartum depression: Is there a link? Archives of Women's Mental Health, 4(3), 83-92. http://dx.doi.org/10.1007/s007370200004

Cox, J. L. (1983). Postnatal depression: a comparison of African and Scottish women. Social Psychiatry, 18(1), 25-28. https://doi.org/10.1007/BF00583384

Cox, J. L., Chapman, G., Murray, D., & Jones, P. (1996). Validation of the Edinburgh postnatal depression scale (EPDS) in non-postnatal women. Journal of Affective Disorders, 39(3), 185-189. https://doi.org/10.1016/0165-0327(96)00008-0

Cox, J. L., & Holden, J. (2003). Perinatal mental health: a guide to the Edinburgh Postnatal Depression Scale (EPDS). London: Gaskell.

Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782-786. https://doi.org/10.1192/bjp.150.6.782

Derogatis, L. R., Lipman, R. S., & Covi, L. (1973). SCL-90: an outpatient psychiatric rating scale--preliminary report. Psychopharmacology Bulletin, 9(1), 13-28.

Diagnostic and statistical manual of mental disorders, fourth edition. (1994). Washington, DC: American Psychiatric Association.

Diagnostic and statistical manual of mental disorders, third edition revised. (1987). Washington, DC: American Psychiatric Association.

Donaghy, M. E. (2007). Exercise can seriously improve your mental health: fact or fiction? Advances in Physiotherapy, 9(2), 76 -88. https://doi.org/10.1080/14038190701395838

Dreggevik, E. K. (2008). Hvordan opplever mødre med mulig fødselsdepresjon sin livssituasjon og hvilke erfaringer har de i møte med helsesøsterog Edinburgh Postnatal Depression Scale? (Master), University of Stavanger, Stavanger.

Dørheim, S. K., Bjorvatn, B., & Eberhard-Gran, M. (2012). Insomnia and depressive symptoms in late pregnancy: a population-based study. Behav Sleep Med, 10(3), 152-166. https://doi.org/10.1080/15402002.2012.660588

Dørheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2009a). Sleep and depression in postpartum women: A population-based study. Sleep: Journal of Sleep and Sleep Disorders Research, 32(7), 847-855. https://doi.org/10.1093%2Fsleep%2F32.7.847

Dørheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2009b). Subjective and objective sleep among depressed and non-depressed postnatal women. Acta Psychiatrica Scandinavica, 119(2), 128-136. http://dx.doi.org/10.1111/j.1600-0447.2008.01272.x

Dørheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2011). Sleep and depression among postnatal women - A population based questionnaire study supplemented by sleep diary and actigraphy. Archives of Women's Mental Health, 14, S17-S18. http://dx.doi.org/10.1007/s00737-010-0203-1

Eberhard-Gran, M., Eskild, A., Samuelsen, S., & Tambs, K. (2007). A short matrix-version of the Edinburgh Depression Scale. Acta Psychiatrica Scandinavica, 116(3), 195-200. http://dx.doi.org/10.1111/j.1600-0447.2006.00934.x

Eberhard-Gran, M., Eskild, A., Tambs, K., Opjordsmoen, S., & Samuelsen, S. O. (2001). Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatrica Scandinavica, 104(4), 243-249. http://dx.doi.org/10.1034/j.1600-0447.2001.00187.x

Eberhard-Gran, M., Eskild, A., Tambs, K., Samuelsen, S. O., & Opjordsmoen, S. (2002). Depression in postpartum and non-postpartum women: prevalence and risk factors. Acta Psychiatrica Scandinavica, 106(6), 426-433. https://doi.org/10.1034/j.1600-0447.2002.02408.x

Eberhard-Gran, M., Eskild, A., Tambs, K., Schei, B., & Opjordsmoen, S. (2001). The Edinburgh Postnatal Depression Scale: Validation in a Norwegian community sample. Nordic Journal of Psychiatry, 55(2), 113-117. http://dx.doi.org/10.1080/08039480151108525

Eberhard-Gran, M., Schei, B., & Eskild, A. (2007). Somatic symptoms and diseases are more common in women exposed to violence. Journal of General Internal Medicine, 22(12), 1668-1673. http://dx.doi.org/10.1007/s11606-007-0389-8

Eberhard-Gran, M., & Slinning, K. (2007). Nedstemthet og depresjon i forbindelse med fødsel. Oslo: Nasjonalt folkehelseinstitutt.

Eberhard-Gran, M., Tambs, K., Opjordsmoen, S., Skrondal, A., & Eskild, A. (2004). Depression during pregnancy and after delivery: A repeated measurement study. Journal of Psychosomatic Obstetrics & Gynecology, 25(1), 15-21. http://dx.doi.org/10.1080/01674820410001737405

European Federation of Pscyhologist Association (EFPA). (2008). EFPA Review model for the description and evaluation of psychological tests: Test review form and notes for reviewers (3.42 ed.): EFPA.

Forman, D. N., Videbech, P., Hedegaard, M., Salvig, J. D., & Secher, N. J. (2000). Postpartum depression: Identification of women at risk. British Journal of Obstetrics and Gynaecology, 107(10), 1210-1217. https://doi.org/10.1111/j.1471-0528.2000.tb11609.x

Garthus-Niegel, S., Storksen, H. T., Torgersen, L., Von Soest, T., & Eberhard-Gran, M. (2011). The Wijma Delivery Expectancy/Experience Questionnaire - A factor analytic study. Journal of Psychosomatic Obstetrics & Gynecology, 32(3), 160-163. http://dx.doi.org/10.3109/0167482X.2011.573110

Gibson, J., McKenzie-McHarg, K., Shakespeare, J., Price, J., & Gray, R. (2009). A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatrica Scandinavica, 119(5), 350-364. http://dx.doi.org/10.1111/j.1600-0447.2009.01363.x

Glavin, K. (2012). Preventing and treating postpartum depression in women - a municipality model. Journal of Research in Nursing, 17(2), 142-156. http://dx.doi.org/10.1177/1744987111433447

Glavin, K., Ellefsen, B., & Erdal, B. (2010). Norwegian public health nurses' experience using a screening protocol for postpartum depression. Public Health Nursing, 27(3), 255-262. http://dx.doi.org/10.1111/j.1525-1446.2010.00851.x

Glavin, K., Smith, L., & Sorum, R. (2009). Prevalence of postpartum depression in two municipalities in Norway. Scandinavian Journal of Caring Sciences, 23(4), 705-710. http://dx.doi.org/10.1111/j.1471-6712.2008.00667.x

Glavin, K., Smith, L., Sørum, R., & Ellefsen, B. (2010a). Redesigned community postpartum care to prevent and treat postpartum depression in women--A one-year follow-up study. Journal of Clinical Nursing, 19(21-22), 3051-3062. http://dx.doi.org/10.1111/j.1365-2702.2010.03332.x

Glavin, K., Smith, L., Sørum, R., & Ellefsen, B. (2010b). Supportive counselling by public health nurses for women with postpartum depression. Journal of Advanced Nursing, 66(6), 1317-1327. http://dx.doi.org/10.1111/j.1365-2648.2010.05263.x

Glaze, R., & Cox, J. L. (1991). Validation of a computerised version of the 10-item (self-rating) Edinburgh Postnatal Depression Scale. Journal of Affective Disorders, 22(1-2), 73-77. https://doi.org/10.1016/0165-0327(91)90086-8

Grote, V., Vik, T., von Kries, R., Luque, V., Socha, J., Verduci, E., et al. (2010). Maternal postnatal depression and child growth: A European cohort study. BMC Pediatrics, 10(14). http://dx.doi.org/10.1186/1471-2431-10-14

Haga, S. M., Kalkvik, H., Slinning, K., Kraft, P., Steen, T., & Staff, A. T. (2011). Postpartum depressive symptoms and life satisfaction: The role of self-efficacy and social support. Archives of Women's Mental Health, 14, S69. http://dx.doi.org/10.1007/s00737-010-0203-1

Haga, S. M., Ulleberg, P., Slinning, K., Kraft, P., Steen, T. B., & Staff, A. (2012). A longitudinal study of postpartum depressive symptoms: Multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support. Archives of Women's Mental Health, 15(3), 175-184. http://dx.doi.org/10.1007/s00737-012-0274-2

Helbig, A., Kaasen, A., Malt, U. F., & Haugen, G. (2010). The impact of maternal psychological distress on the feto-placental circulation: Does gestational age matter? Journal of Psychosomatic Obstetrics and Gynecology, 31, 58. http://dx.doi.org/10.3109/0167482x.2010.536387

Helbig, A., Kaasen, A., Malt, U. F., & Haugen, G. (2011). Does maternal psychological distress in second trimester of pregnancy affect feto-placental volume blood flow in third trimester? Placenta, 32 (9), A98. http://dx.doi.org/10.1016/j.placenta.2011.07.004

Henshaw, C., Barton, J., & Cox, J. L. (2009). Modern management of perinatal psychiatric disorders. London: RCPsych Publications.

Henshaw, C., & Elliott, S. (2005). Screening for perinatal depression. London: Jessica Kingsley.

Jenum, A. K., Sletner, L., Voldner, N., Vangen, S., Morkrid, K., Andersen, L. F., et al. (2010). The STORK Groruddalen research programme: A population-based cohort study of gestational diabetes, physical activity, and obesity in pregnancy in a multiethnic population. Rationale, methods, study population, and participation rates. Scandinavian Journal of Public Health, 38(Suppl 5), 60-70. http://dx.doi.org/10.1177/1403494810378921

Kaasen, A., Helbig, A., Malt, U. F., Godang, K., Bollerslev, J., Naes, T., & Haugen, G. (2012). The relation of psychological distress to salivary and serum cortisol levels in pregnant women shortly after the diagnosis of a structural fetal anomaly. Acta Obstetricia et Gynecologica Scandinavica, 91(1), 68-78. http://dx.doi.org/10.1111/j.1600-0412.2011.01266.x

Kaasen, A., Helbig, A., Malt, U. F., Naes, T., Skari, H., & Haugen, G. (2010). Acute maternal social dysfunction, health perception and psychological distress after ultrasonographic detection of a fetal structural anomaly. BJOG: An International Journal of Obstetrics & Gynaecology, 117(9), 1127-1138. https://doi.org/10.1111/j.1471-0528.2010.02622.x

Krantz, I., Eriksson, B., Lundquist-Persson, C., Ahlberg, B. M., & Nilstun, T. (2008). Screening for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS): An ethical analysis. Scandinavian Journal of Public Health, 36(2), 211-216. https://doi.org/10.1177/1403494807085392

Lloyd-Williams, M. (2000). Difficulties in diagnosing and treating depression in the terminally ill cancer patient. Postgraduate Medical Journal, 76(899), 555-558. https://doi.org/10.1136/pmj.76.899.555

Lukasse, M., Vangen, S., Øian, P., Kumle, M., Ryding, E. L., & Schei, B. (2010). Childhood abuse and fear of childbirth--A population-based study. Birth: Issues in Perinatal Care, 37(4), 267-274. http://dx.doi.org/10.1111/j.1523-536X.2010.00420.x

Lundh, W., & Gyllang, C. (1993). Use of the Edinburgh postnatal depression scale in some Swedish child health care centers. Scandinavian Journal of Caring Sciences, 7(3), 149-154. https://doi.org/10.1111/j.1471-6712.1993.tb00190.x

Matthey, S. (2004). Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale. Journal of Affective Disorders, 78(3), 269-272. https://doi.org/10.1016/s0165-0327(02)00313-0

Matthey, S. (2008). Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders. Depression and Anxiety, 25(11), 926-931. https://doi.org/10.1002/da.20415

Matthey, S., Barnett, B., Kavanagh, D. J., & Howie, P. (2001). Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. Journal of Affective Disorders, 64(2), 175-184. https://doi.org/10.1016/s0165-0327(00)00236-6

Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 134(4), 382-389. https://doi.org/10.1192/bjp.134.4.382

Moran, T. E., & O’Hara, M. W. (2006). A partner-rating scale of postpartum depression: The Edinburgh Postnatal Depression Scale – Partner (EPDS-P). Archives of Women's Mental Health, 9(4), 173-180. https://doi.org/10.1007/s00737-006-0136-x

Murray, D., & Cox, J. L. (1990). Screening for depression during pregnancy with the Edinburgh depression scale (EDDS). Journal of Reproductive and Infant Psychology, 8(2), 99-107. https://doi.org/10.1080/02646839008403615

Nordeng, H., Hansen, C., Garthus-Niegel, S., & Eberhard-Gran, M. (2012). Fear of childbirth, mental health, and medication use during pregnancy. Archives of Women's Mental Health, 15(3), 203-209. http://dx.doi.org/10.1007/s00737-012-0278-y

Olsen, E. (2011). Preventing postpartum depression: A Web-based intervention. Archives of Women's Mental Health, 14, S77. http://dx.doi.org/10.1007/s00737-010-0203-1

Perris, C. (1986). Ratings of depression with a subscale of the CPRS. In N. Sartorius & T. A. Ban (Eds.), Assessment of depression. Berlin: Springer-Verlag.

Reichenheim, M., Moraes, C., Oliveira, A., & Lobato, G. (2011). Revisiting the dimensional structure of the Edinburgh Postnatal Depression Scale (EPDS): empirical evidence for a general factor. BMC Medical Research Methodology, 11(1), 93. https://doi.org/10.1186/1471-2288-11-93

Rubertsson, C., Börjesson, K., Berglund, A., Josefsson, A., & Sydsjö, G. (2011). The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nordic Journal of Psychiatry, 65(6), 414-418. https://doi.org/10.3109/08039488.2011.590606

Saastad, E., Israel, P., Ahlborg, T., Gunnes, N., & Frøen, J. F. (2011). Fetal movement counting-effects on maternal-fetal attachment: A multicenter randomized controlled trial. Birth: Issues in Perinatal Care, 38(4), 282-293. http://dx.doi.org/10.1111/j.1523-536X.2011.00489.x

Saastad, E., Winje, B. A., Israel, P., & Frøen, J. (2012). Fetal movement counting-maternal concern and experiences: A multicenter, randomized, controlled trial. Birth: Issues in Perinatal Care, 39(1), 10-20. http://dx.doi.org/10.1111/j.1523-536X.2011.00508.x

Severinsson, E. (2007). The relationship between postpartum depression, breastfeeding, DHA and seafood consumptions. Paper presented at the Japan - Norway bilateral cooperation. The relationship between postpartum depression, breastfeeding, DHA* and seafood consumption, Stavanger.

Solberg, O., Dale, M. T. G., Holmstrøm, H., Eskedal, L. T., Landolt, M. A., & Vollrath, M. E. (2011). Emotional reactivity in infants with congenital heart defects and maternal symptoms of postnatal depression. Archives of Women's Mental Health, 14(6), 487-492. https://doi.org/10.1007/s00737-011-0243-1

Songøygard, K. M., Stafne, S. N., Evensen, K. A. I., Salvesen, K. A., Vik, T., & Mørkved, S. (2012). Does exercise during pregnancy prevent postnatal depression?: A randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 91(1), 62-67. http://dx.doi.org/10.1111/j.1600-0412.2011.01262.x

Spitzer, R. L., Endicott, J., & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35(6), 773-782. https://doi.org/10.1001/archpsyc.1978.01770300115013

Spitzer, R. L., Williams, J. B., Kroenke, K., Linzer, M., deGruy, F. V., 3rd, Hahn, S. R., . . . Johnson, J. G. (1994). Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA, 272(22), 1749-1756. https://doi.org/10.1001/jama.1994.03520220043029

Storksen, H. T., Eberhard-Gran, M., Garthus-Niegel, S., & Eskild, A. (2012). Fear of childbirth; The relation to anxiety and depression. Acta Obstetricia et Gynecologica Scandinavica, 91(2), 237-242. http://dx.doi.org/10.1111/j.1600-0412.2011.01323.x

Vik, K., Aass, I. M., Willumsen, A. B., & Hafting, M. (2009). "It's about focusing on the mother's mental health": Screening for postnatal depression seen from the health visitors' perspective--A qualitative study. Scandinavian Journal of Public Health, 37(3), 239-245. http://dx.doi.org/10.1177/1403494808100275

Vik, T., Grote, V., Escribano, J., Socha, J., Verduci, E., Fritsch, M., . . . Koletzko, B. (2009). Infantile colic, prolonged crying and maternal postnatal depression. Acta Paediatrica, 98(8), 1344-1348. http://dx.doi.org/10.1111/j.1651-2227.2009.01317.x

von Knorring, L. (2003). Review of Depression in women with focus on the postpartum period. [Authors: Gran, Malin Eberhard Title: Depression in women with focus on the postpartum period Year: 2003 Other Info: Doctoral Dissertation, Division of Epidemiology, Norwegian Institute of Public Health, Oslo University, Oslo, Norway, 2003]. Nordic Journal of Psychiatry, 57(5), 390. http://dx.doi.org/10.1080/08039480310002769

Wickberg, B., & Hwang, C. P. (1996). The Edinburgh Postnatal Depression Scale: Validation on a Swedish community sample. Acta Psychiatrica Scandinavica, 94(3), 181-184. https://doi.org/10.1111/j.1600-0447.1996.tb09845.x

Downloads

Additional Files

Published

2012-12-14

How to Cite

Hanssen-Bauer, K., & Welander-Vatn, A. (2012). Måleegenskaper ved den norske versjonen av Edinburgh Postnatal Depression Scale (EPDS). PsykTestBarn, 2(2), 1–16. https://doi.org/10.21337/0017

Issue

Section

Kunnskapsoppsummeringer