Sensitivity and Specificity of the Edinburgh Postnatal Depression Scale (EPDS) among Iranian Mothers: A Psychometric Study

There are few psychometric studies addressing sensitivity and specificity of the Persian version of the Edinburgh Postnatal Depression Scale (EPDS). Therefore, there is a need for future studies to identify the best cut-off point for EPDS score. The present study is aimed at assessing the validity of the EPDS among Iranian mothers. The study is a secondary analysis on a descriptive correlational design to evaluate the sensitivity and the specificity of the Persian version of EPDS. The study was conducted in Mashhad, Iran, among 200 postpartum women attending routine post-natal care at six health service centers selected through stratified sampling method, and mothers completed the EPDS tool. Statistical analyses were performed using SPSS software version 16.0. The sensitivity and specificity of the EPDS were assessed against the DSM-IV criteria for depression with Receiver operating characteristic (ROC) curves using MedCalc statistical software (version 13.0). 30% of mothers were depressed based on the Edinburgh scale. The best cut-off point to discriminate mothers with depression (a combination major and minor depression) from normal women in postpartum period was >10 with sensitivity 87.95% and specificity 93.86%. The highest area under the receiver operating characteristic curve (ROC= 0.959). For women with major depression, the best cut-off point was 16 with sensitivity 94.12% and specificity 94.54% (ROC= 0.98). In conclusion, the finding of this psychometric study showed the Persian version of  EPDS can be used  as a valid tool at a cut-off score of >10 to screen mothers with a combination major and minor depression  and  at cut-off score of >16 for screening those with major depression  in postpartum period in health care center.