Abstract

Background. The postpartum period represents the time of risk for the emergence of maternal postpartum depression. Postpartum depression (PPD) is associated with significant emotional and social impairements that impact women and their partners. Maternal depression is considered a risk factor for the socioemotional and cognitive development of children. It therefore seems important to detect and treat depression during the postnatal period as early as possible to avoid harmful consequences. Because PPD is a significant mental health problem, there is a need for reliable and valid screening instruments.
Purpose. The Edinburgh Postnatal Depression Scale (EPDS) is widely used in many countries to screen women for depression in the perinatal period. No validated screening instruments for detecting postnatal depression have been available in Estonian. The current investigation sought to find the reliable cut-off for depression.
Methods. Altogether 389 women completed a questionnaire with the EPDS and Emotional State Questionnaire (EST-Q2) depression subscale. For the EPDS, a receiver operating characteristic (ROC) curve was calculated for prediction of depression. Also, the Youden Index was calculated. Sensitivity, specificity, positive predictive value, negative predictive value and area under the ROC curve were computed from the data for all relevant cut-off values. A score of 11 or more was found to be the optimal cut-off for depression.
Conclusions. The study confirms that the EPDS is a valid screening instrument for detection of depressive symptoms. The Estonian EPDS provides reliable measurement outcomes with an optimal cut-off at ≥11.