title: Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period.
abstract: BACKGROUND
  Relatively few studies have focused on the validation of psychometric scales measuring depression during pregnancy. The aim of this review was to critically appraise and review antenatal validation studies of the Edinburgh Postnatal Depression Scale (EPDS).
  
  
  METHODS
  A systematic search was performed in MEDLINE, EMBASE, ISI, CINAHL, SCIELO and PsyCINFO for the period 1987-2013.
  
  
  RESULTS
  Eleven validation studies met the inclusion criteria. The study design varied between studies. Sensitivity and specificity estimates also varied between 64-100% and 73-100%, respectively. The confidence interval estimates also showed a high degree of variability. Our estimates suggest lower positive predictive values in the general population than those reported in the validation study samples. The sensitivity values in validation studies of the EPDS show fairly large variability, ranging from good to acceptable.
  
  
  CONCLUSIONS
  Future studies should have larger sample sizes and include both representative and clinical samples and look at the psychometric performance of the EPDS in each trimester.
  
  
  CONCLUSIONS
  Due to differences in study design and variation in the cultural/linguistic adaptation, uncertainty remains regarding the comparability of the sensitivity and specificity estimates of different EPDS versions. Future studies should have larger sample sizes, include both representative and clinical samples, and look at the psychometric performance of the EPDS in each trimester. Reporting quality, especially as regards checks to ensure content validity, should be improved.
authors.affiliation: Reproductive Medicine, Department of Obstetrics and Gynaecology, Karolinska University Hospital Huddinge, Reproduktionsmedicin Huddinge, Novum Plan 4, Huddinge Stockholm 14186, Sweden. Electronic address: kozinszky@gmail.com.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Kozinszky
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke׳s Hospital, Cambridge, United Kingdom; Psychiatric Liaison Service, Ipswich, Norfolk and Suffolk NHS Foundation Trust.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Dudas
mesh_terms: D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D054928:Validation Studies as Topic
keywords: Antepartum; Edinburgh Postnatal Depression Scale; Review; Validation