Phillips Jane, Charles Margaret, Sharpe Louise, Matthey Stephen
University of Sydney, Australia.
J Affect Disord. 2009 Nov;118(1-3):101-12. doi: 10.1016/j.jad.2009.02.004. Epub 2009 Mar 10.
The Edinburgh Postnatal Depression Scale (EPDS) was developed as a uni-dimensional measure of depression, however there is evidence that it also measures anxiety. This study examined the factor structure of the EPDS and validity of the identified subscales.
309 women with infants aged up to 12 months completed the EPDS, BDI-II, BAI and the SCID-I.
Exploratory factor analysis revealed distinct anxiety and depression factors. Confirmatory factor analyses showed the identified two-factor model to be an adequate fit to the data and superior to a uni-dimensional model. An anxiety subscale score of 4 or more detected the presence of an anxiety disorder with sensitivity of 63%, specificity 70%, positive predictive value of 45% and negative predictive value of 81%.
All participants were mothers with unsettled infants, a group that is known to have higher than average rates of depression and anxiety. The factor structure of the EPDS may have unique features in this group and so these results may not be generalizable to general postnatal samples. Also, participants in this study ranged from 1 week to 12 months postpartum and there may be variations in the factor structure of the EPDS over this time.
The 7-item depression subscale could be used in place of the total scale to identify women with major depression and the 3-item anxiety subscale could be used to identify women with anxiety disorders (occurring co-morbidly with depression or occurring alone). Future research should seek to replicate these findings in a general postnatal sample and to develop anxiety-specific screening tools for use in the postnatal period.
爱丁堡产后抑郁量表（EPDS）最初是作为一种抑郁症的单维度测量工具而开发的，但有证据表明它也能测量焦虑。本研究探讨了EPDS的因子结构以及所确定子量表的有效性。
309名婴儿年龄在12个月以下的女性完成了EPDS、贝克抑郁量表第二版（BDI-II）、贝克焦虑量表（BAI）和精神障碍诊断与统计手册第一版（SCID-I）。
探索性因子分析揭示了不同的焦虑和抑郁因子。验证性因子分析表明，所确定的双因子模型与数据拟合良好，且优于单维度模型。焦虑子量表得分4分及以上可检测出焦虑症，其敏感性为63%，特异性为70%，阳性预测值为45%，阴性预测值为81%。
所有参与者均为婴儿睡眠不安稳的母亲，这一群体的抑郁和焦虑发生率高于平均水平。EPDS的因子结构在该群体中可能具有独特特征,因此这些结果可能无法推广到一般产后样本。此外，本研究中的参与者产后时间从1周到12个月不等，在此期间EPDS的因子结构可能存在差异。
7项抑郁子量表可用于替代总量表来识别重度抑郁症女性，3项焦虑子量表可用于识别患有焦虑症的女性（与抑郁症共病或单独出现）。未来的研究应寻求在一般产后样本中重复这些发现，并开发用于产后的焦虑特异性筛查工具。
