PRIISM Applied Statistics Center, New York University, New York, NY, USA.
Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA.
Acta Psychiatr Scand. 2021 Apr;143(4):348-362. doi: 10.1111/acps.13272. Epub 2021 Jan 19.
This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression screening in pregnancy and postpartum, based on objective criteria.
Item responses from the 10-item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary screening accuracy studies that compared the EPDS to the Structured Clinical Interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of screening accuracy of the EPDS as compared to the SCID.
A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91).
The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
本研究使用大型数据库，根据客观标准，从包含 10 个项目的爱丁堡产后抑郁量表（EPDS）中开发出一种可靠且有效的简短形式，该量表为自我报告问卷，用于孕期和产后的抑郁筛查。
从 22 项初步筛查准确性研究中获得了 5157 名参与者（765 例重度抑郁症）的 EPDS 第 10 项回答，这些研究将 EPDS 与 DSM 结构化临床访谈（SCID）进行了比较。使用验证性因子分析验证 EPDS 潜在结构的单维性，并拟合项目反应理论模型。最优测试组装（OTA）方法为每个可能的 1-9 项量表长度确定了一个信息量最大的简短形式。根据预定义的有效性和可靠性标准以及 EPDS 与 SCID 相比的筛查准确性非劣效性，选择最终的简短形式。
选择了 EPDS 的 5 项简短形式（EPDS-Dep-5）。EPDS-Dep-5 的 Cronbach's alpha 为 0.82。EPDS-Dep-5 的截断值为 4 或更高时的敏感性和特异性分别为 0.83（95%置信区间，0.73，0.89）和 0.86（95%置信区间，0.80，0.90），与 EPDS 相比具有统计学非劣效性。总分与完整 EPDS 的相关性很高（r=0.91）。
与完整的 EPDS 相比，EPDS-Dep-5 是一种有效的简短形式，几乎没有信息丢失。EPDS-Dep-5 是使用客观的、预先指定的标准，通过 OTA 方法开发的，但该方法是数据驱动和探索性的。因此，需要在不同人群中复制本研究的结果。
