Measuring depression in women around menopausal age: towards a validation of the Edinburgh Depression Scale.
BACKGROUND
The relationship between menopause and depression is still rather unclear. Studies using different methodology - especially those lacking a clear definition of depression - are hardly comparable. Since the Edinburgh Depression Scale (EDS) is not influenced by (menopause-related) somatic symptoms, the validity of the Dutch version of this instrument was investigated in a large community sample of menopausal women.


METHODS
In 951 women, aged between 47 and 56 years, depressive symptomatology was measured using the EDS, together with a syndromal diagnosis of depression using Research Diagnostic Criteria.


RESULTS
Twenty-two percent of the subjects had scores of 12 or higher on the EDS. With this cut-off point, depression (major or minor) was detected with a sensitivity of 66%, a specificity of 89%, and a positive predictive value (PPV) of 62%. A cut-off score of 15 or higher detected half of the women with major depression (sensitivity 73%, specificity 93%, PPV 53%).


CONCLUSIONS
Screening of depressive symptomatology at menopausal age in women of the community can only partly detect women with clinical depression. The relation between menopausal status and depression should preferentially be investigated using a longitudinal rather than a cross-sectional design.


CONCLUSIONS
The EDS, which is easy to implement in both community and clinical settings (e.g., General Practice), might be used as an effective screening tool for detecting women at menopausal age who are at risk for depression, followed by clinical evaluation in those with high scores.
Tilburg University, Department of Clinical Health Psychology, P.O. Box 90153, 5000 LE Tilberg, The Netherlands.
M C
MC
Becht
C F
CF
Van Erp
T M
TM
Teeuwisse
G L
GL
Van Heck
M J
MJ
Van Son
V J
VJ
Pop
D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012680:Sensitivity and Specificity