Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study

Background: The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item questionnaire developed to identify women at risk for postpartum depression (PD). EPDS symptom patterns appear to vary by nation. The EPDS items and their correlation with affirmative EPDS screens have thus far been minimally s...

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Main Authors: Bied, Adam, Njuguna, Susan, Mohd Shukri, Nurul Husna, Zainudin, Zurina
Format: Article
Published: Springer 2023
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author Bied, Adam
Njuguna, Susan
Mohd Shukri, Nurul Husna
Zainudin, Zurina
author_facet Bied, Adam
Njuguna, Susan
Mohd Shukri, Nurul Husna
Zainudin, Zurina
author_sort Bied, Adam
collection UPM
description Background: The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item questionnaire developed to identify women at risk for postpartum depression (PD). EPDS symptom patterns appear to vary by nation. The EPDS items and their correlation with affirmative EPDS screens have thus far been minimally studied among Malaysians. Using positive predictive value (PPV) and negative predictive value (NPV), this study aims to evaluate the EPDS-based psychometric features of individual answer items. Methodology: A cross-section of postpartum women receiving care at two tertiary care facilities in Malaysia underwent screening assessments in the course of receiving treatment. EPDS was employed with an aggregate cutoff score (≥12). EPDS items were assessed as predictors of abnormal EPDS screens. Results: A total of 219 participants were screened, among which 66 were positive on the EPDS. EPDS item responses were collected (item responses 0-3: PPV = 0.07-0.78 and NPV = 0.93-0.22). A negative response to any item strongly predicted a negative EPDS screen (item entry = 0 and NPV = 0.93). Affirmative responses on items 8, 9, and 10 were particularly strong predictors of abnormal EPDS scores, while negative responses to items 3, 5, and 7 were strong predictors of negative EPDS scores. A substantial NPV for any item (response 0 and NPV items 1-10 = 0.93) and a moderate PPV for any affirmative response (responses 1-3, PPV items 1-10 = 0.60) were observed. Conclusions: This is one of the few studies to examine the EPDS item responses among Malaysian women. The results suggest that depression remains prevalent in this postpartum population. Our findings reveal a robust NPV for any negative response to the individual items of the scale, a moderate PPV for any affirmative response, and a particularly robust validity for specific EPDS items. Physical complaints, rather than feelings of sadness, figure prominently in this population, suggesting a tendency among Malaysian women toward somatization.
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spelling upm.eprints-1093342024-08-05T04:02:31Z http://psasir.upm.edu.my/id/eprint/109334/ Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study Bied, Adam Njuguna, Susan Mohd Shukri, Nurul Husna Zainudin, Zurina Background: The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item questionnaire developed to identify women at risk for postpartum depression (PD). EPDS symptom patterns appear to vary by nation. The EPDS items and their correlation with affirmative EPDS screens have thus far been minimally studied among Malaysians. Using positive predictive value (PPV) and negative predictive value (NPV), this study aims to evaluate the EPDS-based psychometric features of individual answer items. Methodology: A cross-section of postpartum women receiving care at two tertiary care facilities in Malaysia underwent screening assessments in the course of receiving treatment. EPDS was employed with an aggregate cutoff score (≥12). EPDS items were assessed as predictors of abnormal EPDS screens. Results: A total of 219 participants were screened, among which 66 were positive on the EPDS. EPDS item responses were collected (item responses 0-3: PPV = 0.07-0.78 and NPV = 0.93-0.22). A negative response to any item strongly predicted a negative EPDS screen (item entry = 0 and NPV = 0.93). Affirmative responses on items 8, 9, and 10 were particularly strong predictors of abnormal EPDS scores, while negative responses to items 3, 5, and 7 were strong predictors of negative EPDS scores. A substantial NPV for any item (response 0 and NPV items 1-10 = 0.93) and a moderate PPV for any affirmative response (responses 1-3, PPV items 1-10 = 0.60) were observed. Conclusions: This is one of the few studies to examine the EPDS item responses among Malaysian women. The results suggest that depression remains prevalent in this postpartum population. Our findings reveal a robust NPV for any negative response to the individual items of the scale, a moderate PPV for any affirmative response, and a particularly robust validity for specific EPDS items. Physical complaints, rather than feelings of sadness, figure prominently in this population, suggesting a tendency among Malaysian women toward somatization. Springer 2023-02-09 Article PeerReviewed Bied, Adam and Njuguna, Susan and Mohd Shukri, Nurul Husna and Zainudin, Zurina (2023) Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study. Cureus: Journal of Medical Science, 15 (2). art. no. e34822. pp. 1-6. ISSN 2168-8184 https://www.cureus.com/articles/134768-psychometric-features-of-the-edinburgh-postnatal-depression-scale-among-malaysian-women-a-cross-sectional-study#!/ 10.7759/cureus.34822
spellingShingle Bied, Adam
Njuguna, Susan
Mohd Shukri, Nurul Husna
Zainudin, Zurina
Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study
title Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study
title_full Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study
title_fullStr Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study
title_full_unstemmed Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study
title_short Psychometric features of the Edinburgh postnatal depression scale among Malaysian women: a cross-sectional study
title_sort psychometric features of the edinburgh postnatal depression scale among malaysian women a cross sectional study
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AT njugunasusan psychometricfeaturesoftheedinburghpostnataldepressionscaleamongmalaysianwomenacrosssectionalstudy
AT mohdshukrinurulhusna psychometricfeaturesoftheedinburghpostnataldepressionscaleamongmalaysianwomenacrosssectionalstudy
AT zainudinzurina psychometricfeaturesoftheedinburghpostnataldepressionscaleamongmalaysianwomenacrosssectionalstudy