Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montréal, QC, H3T 1E4, Canada.
Department of Pediatrics, West China Second University Hospital, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
Sci Rep. 2023 Mar 10;13(1):4026. doi: 10.1038/s41598-023-29114-w.
Item 10 of the Edinburgh Postnatal Depression Scale (EPDS) is intended to assess thoughts of intentional self-harm but may also elicit concerns about accidental self-harm. It does not specifically address suicide ideation but, nonetheless, is sometimes used as an indicator of suicidality. The 9-item version of the EPDS (EPDS-9), which omits item 10, is sometimes used in research due to concern about positive endorsements of item 10 and necessary follow-up. We assessed the equivalence of total score correlations and screening accuracy to detect major depression using the EPDS-9 versus full EPDS among pregnant and postpartum women. We searched Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science from database inception to October 3, 2018 for studies that administered the EPDS and conducted diagnostic classification for major depression based on a validated semi-structured or fully structured interview among women aged 18 or older during pregnancy or within 12 months of giving birth. We conducted an individual participant data meta-analysis. We calculated Pearson correlations with 95% prediction interval (PI) between EPDS-9 and full EPDS total scores using a random effects model. Bivariate random-effects models were fitted to assess screening accuracy. Equivalence tests were done by comparing the confidence intervals (CIs) around the pooled sensitivity and specificity differences to the equivalence margin of δ = 0.05. Individual participant data were obtained from 41 eligible studies (10,906 participants, 1407 major depression cases). The correlation between EPDS-9 and full EPDS scores was 0.998 (95% PI 0.991, 0.999). For sensitivity, the EPDS-9 and full EPDS were equivalent for cut-offs 7-12 (difference range - 0.02, 0.01) and the equivalence was indeterminate for cut-offs 13-15 (all differences - 0.04). For specificity, the EPDS-9 and full EPDS were equivalent for all cut-offs (difference range 0.00, 0.01). The EPDS-9 performs similarly to the full EPDS and can be used when there are concerns about the implications of administering EPDS item 10.Trial registration: The original IPDMA was registered in PROSPERO (CRD42015024785).
爱丁堡产后抑郁量表（EPDS）的第 10 项旨在评估有意伤害自己的想法，但也可能引起对意外伤害自己的担忧。它没有专门针对自杀意念，但有时也被用作自杀倾向的指标。EPDS 的 9 项版本（EPDS-9）省略了第 10 项，由于担心第 10 项的正面评价和必要的后续行动，有时在研究中使用。我们评估了 EPDS-9 与完整 EPDS 总评分相关性和筛查准确性，以检测孕妇和产后妇女的重度抑郁症。我们从数据库成立到 2018 年 10 月 3 日，在 Medline、Medline In-Process 和其他非索引引文、PsycINFO 和 Web of Science 中搜索了使用 EPDS 进行管理并根据经过验证的半结构化或完全结构化访谈对 18 岁或以上孕妇或分娩后 12 个月内的女性进行重度抑郁症诊断分类的研究。我们进行了个体参与者数据荟萃分析。我们使用随机效应模型计算了 EPDS-9 和完整 EPDS 总分之间的 Pearson 相关系数及其 95%预测区间（PI）。使用双变量随机效应模型评估了筛查准确性。通过比较汇总敏感性和特异性差异的置信区间（CI）与 δ = 0.05 的等效边界来进行等效性检验。个体参与者数据来自 41 项符合条件的研究（10906 名参与者，1407 例重度抑郁症）。EPDS-9 和完整 EPDS 评分之间的相关性为 0.998（95%PI 0.991，0.999）。对于敏感性，EPDS-9 和完整 EPDS 在截断值为 7-12 时等效（差值范围为 -0.02，0.01），而在截断值为 13-15 时不确定（所有差值为 -0.04）。对于特异性，EPDS-9 和完整 EPDS 在所有截断值上等效（差值范围为 0.00，0.01）。EPDS-9 的表现与完整 EPDS 相似，当存在对执行 EPDS 第 10 项的影响的担忧时，可以使用。试验注册：原始 IPDMA 在 PROSPERO（CRD42015024785）中注册。
