Review of validation studies of the Edinburgh postnatal depression scale

Objective: To review validation studies of the Edinburgh Postnatal Depressi on Scale (EPDS). Method: A systematic search was performed in Medline and the Science Citati on Index Expanded (ISI) from the period 1987-2000. For sensitivity and spec ificity of the EPDS presented in each study, 95% confidence intervals were estimated. Positive and negative predictive values were estimated assuming prevalences of postpartum depression ranging from 5% to 20%. Results: Eighteen validation studies were identified. The study design vari ed between studies. The sensitivity and specificity estimates also varied: 65-100% and 49-100%, respectively. The confidence intervals were estimated to be wide. Our estimates suggest a lower positive predictive value in a no rmal population than in the validation study samples. Conclusion: Most studies show a high sensitivity of the EPDS. Because of th e differences in study design and large confidence intervals, uncertainty r emains regarding the comparability between the sensitivity and specificity estimates of the different EPDS versions.