A more rational, theory-driven approach to analysing the factor structure of the Edinburgh Postnatal Depression Scale.
We endeavoured to analyze the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) during a screening programme in Hungary, using exploratory (EFA) and confirmatory factor analysis (CFA), testing both previously published models and newly developed theory-driven ones, after a critical analysis of the literature. Between April 2011 and January 2015, a sample of 2967 pregnant women (between 12th and 30th weeks of gestation) and 714 women 6 weeks after delivery completed the Hungarian version of the EPDS in South-East Hungary. EFAs suggested unidimensionality in both samples. 33 out of 42 previously published models showed good and 6 acceptable fit with our antepartum data in CFAs, whilst 10 of them showed good and 28 acceptable fit in our postpartum sample. Using multiple fit indices, our theory-driven anhedonia (items 1,2) - anxiety (items 4,5) - low mood (items 8,9) model provided the best fit in the antepartum sample. In the postpartum sample, our theory-driven models were again among the best performing models, including an anhedonia and an anxiety factor together with either a low mood or a suicidal risk factor (items 3,6,10). The EPDS showed moderate within- and between-culture invariability, although this would also need to be re-examined with a theory-driven approach.
Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden; Health Research and Health Promotion Research Group, Teacher Training Faculty, College of Kecskemét, Kecskemét, Hungary. Electronic address: kozinszky@gmail.com.
Zoltan
Z
Kozinszky
Department of Obstetrics and Gynaecology, University of Szeged, Szeged, Hungary.
Annamária
A
Töreki
Department of Obstetrics and Gynaecology, University of Szeged, Szeged, Hungary.
Emőke A
EA
Hompoth
Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; OPMHS, Cambridgeshire and Peterborough Foundation Trust, Cambridge, United Kingdom; University of East Anglia, Norwich, United Kingdom.
Robert B
RB
Dudas
Department of Obstetrics and Gynaecology, University of Szeged, Szeged, Hungary.
Gábor
G
Németh
D000328:Adult; D059445:Anhedonia / Q000502:physiology; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards; D015203:Reproducibility of Results; D012307:Risk Factors; D059020:Suicidal Ideation
Antepartum depression; Edinburgh Postnatal Depression Scale; Factor structure; Postpartum depression; Theory-driven models