Newly identified severity descriptors for scores on the Edinburgh Postnatal Depression Scale (EPDS)

What is it about?

This study established depression severity level descriptors for scores on the Edinburgh Postnatal Depression Scale (EPDS). In this study, 1516 postpartum women completed both the EPDS and the Beck Depression Inventory (BDI). Because, the BDI has established depression severity classifications, we were able to use the statistical method of "equipercentile linking" to identify concordance between EPDS and BDI scores. Once concordance between scores on the two scales was established, then BDI severity classifications could be applied to the equivalent EPDS scores.

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Why is it important?

In both clinical and research settings, a cutoff scores on the EPDS is used to identify women with probable depression. However grouping women into one of two groups (depressed/not depressed), suggest equivalence among women with EPDS scores as different as 13 and 30! Depression severity descriptors for EPDS scores are useful both clinically and in research. In clinical practice, while women with severe depression severity might be referred to a mental-health specialist, women with less severe depression symptoms might benefit from a wider array of approaches. In research, enrollment of women with a wide range of depression severity into treatment trials might obscure treatment effects. Specifically, change is EPDS scores is typically smaller among those with lower scores at enrollment; not because the treatment is less effective in this group but simply because moving from above a cutoff score of 13 to below, requires less change than moving from 30 to below 13. The EPDS severity descriptors allows treatment researchers higher specificity in selecting their participants, or to group participants as mild, moderately or severely depressed and to examine change in severity category rather than absolute change in EPDS score.

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