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Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item.

Publication ,  Journal Article
Qiu, X; Wu, Y; Sun, Y; Levis, B; Tian, J; Boruff, JT; Cuijpers, P; Ioannidis, JPA; Markham, S; Ziegelstein, RC; Vigod, SN; Benedetti, A ...
Published in: Scientific reports
March 2023

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).

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Published In

Scientific reports

DOI

EISSN

2045-2322

ISSN

2045-2322

Publication Date

March 2023

Volume

13

Issue

1

Start / End Page

4026

Related Subject Headings

  • Suicidal Ideation
  • Psychiatric Status Rating Scales
  • Pregnancy
  • Humans
  • Female
  • Depressive Disorder, Major
  • Depression, Postpartum
  • Depression
 

Citation

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Qiu, X., Wu, Y., Sun, Y., Levis, B., Tian, J., Boruff, J. T., … DEPRESsion Screening Data (DEPRESSD) EPDS Group, . (2023). Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific Reports, 13(1), 4026. https://doi.org/10.1038/s41598-023-29114-w
Qiu, Xia, Yin Wu, Ying Sun, Brooke Levis, Jizhou Tian, Jill T. Boruff, Pim Cuijpers, et al. “Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item.Scientific Reports 13, no. 1 (March 2023): 4026. https://doi.org/10.1038/s41598-023-29114-w.
Qiu X, Wu Y, Sun Y, Levis B, Tian J, Boruff JT, et al. Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific reports. 2023 Mar;13(1):4026.
Qiu, Xia, et al. “Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item.Scientific Reports, vol. 13, no. 1, Mar. 2023, p. 4026. Epmc, doi:10.1038/s41598-023-29114-w.
Qiu X, Wu Y, Sun Y, Levis B, Tian J, Boruff JT, Cuijpers P, Ioannidis JPA, Markham S, Ziegelstein RC, Vigod SN, Benedetti A, Thombs BD, DEPRESsion Screening Data (DEPRESSD) EPDS Group. Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific reports. 2023 Mar;13(1):4026.

Published In

Scientific reports

DOI

EISSN

2045-2322

ISSN

2045-2322

Publication Date

March 2023

Volume

13

Issue

1

Start / End Page

4026

Related Subject Headings

  • Suicidal Ideation
  • Psychiatric Status Rating Scales
  • Pregnancy
  • Humans
  • Female
  • Depressive Disorder, Major
  • Depression, Postpartum
  • Depression