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Research ArticleOriginal Research

Concordance of Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) to Assess Increased Risk of Depression among Postpartum Women

Barbara P. Yawn, Wilson Pace, Peter C. Wollan, Susan Bertram, Margary Kurland, Deborah Graham and Allen Dietrich
The Journal of the American Board of Family Medicine September 2009, 22 (5) 483-491; DOI: https://doi.org/10.3122/jabfm.2009.05.080155
Barbara P. Yawn
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Wilson Pace
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Peter C. Wollan
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Susan Bertram
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Margary Kurland
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Deborah Graham
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Allen Dietrich
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Article Figures & Data

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  • Figure 1.
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    Figure 1.

    Study diagram. EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire; PP, postpartum; F/U, follow-up.

  • Figure 2.
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    Figure 2.

    Comparison of EPDS and PHQ-9 scores by categories of risk. Darkly shaded areas are concordant between the level of risk identified by the EPDS and the PHQ-9. The lightly shaded area represents those who fall into the PHQ-9 group that have “mild symptoms and require repeat PHQ-9.”42 EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire.

Tables

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    Table 1.

    Categories of Edinburgh Postnatal Depression Scale (18) and Patient Health Questionnaire-9 (42) scores

    EPDS ScoreInterpretationPHQ-9
    ScoreInterpretation
    0-9“Normal”0-4“Normal”
    10, 11“Slightly increased risk”5-9“Mild depressive symptoms”; “repeat PHQ-9 at follow-up”
    12-15“Increased risk”10-14“Moderate depressive symptoms”
    ≥16“Likely depression”≥15“Moderately severe to severe depressive symptoms”
    • EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire.

    • View popup
    Table 2.

    Response to Suicidal Ideation Questions on Screeners

    Screening ToolSuicidal IssuesResponse
    EPDSNeverNormal
    Hardly everSuicidal ideation requiring evaluation
    SometimesSuicidal ideation requiring evaluation
    OftenSuicidal ideation requiring evaluation
    PHQ-9Not at allNormal
    Several daysSuicidal ideation requiring evaluation
    >Half the daysSuicidal ideation requiring evaluation
    Nearly every daySuicidal ideation requiring evaluation
    • EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire.

    • View popup
    Table 3.

    Demographics of Women Completing EPDS and PHQ-9 (n = 481)

    AgeMarried*Completed High School†Employed Outside Home‡Income >$30,000/year§
    18 to 19 (n = 57)21 (36.8)46 (80.7)18 (31.6)6 (10.5)
    20 to 24 (n = 154)78 (50.6)125 (81.1)71 (46.1)29 (18.8)
    25 to 29 (n = 137)97 (70.8)119 (86.9)65 (47.4)72 (52.6)
    30 to 34 (n = 86)71 (82.6)81 (94.2)50 (58.1)58 (67.4)
    ≥35 (n = 46)33 (71.7)42 (91.3)28 (60.9)28 (60.9)
    • All values provided as n (%). Percents are by age group.

    • * P < .0001 (χ2 test of row variation).

    • † P = .04 (χ2 test of row variation).

    • ‡ P = .01 (χ2 test of row variation).

    • § P < .0001 (χ2 test of row variation).

    • EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire.

    • View popup
    Table 4.

    EPDS Versus PHQ-9 Scores by Category (n = 481)

    EPDS ScorePHQ-9 Score
    ≤4; “Normal”5-9; “Reevaluate”10-14; “Increased Risk of Depression”≥15; “Very Likely to Have Depression”
    <0-9; “normal”249 (51.8)77 (16.0)15 (3.1)2 (0.4)
    10, 11; “slightly increased risk”11 (2.2)17 (3.5)7 (1.5)1 (0.2)
    12-15; “increased risk”11 (2.2)22 (4.6)20 (4.2)11 (2.3)
    ≥16; “marked risk”04 (0.8)12 (2.5)22 (4.6)
    • All values provided as n (%).

    • EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire.

    • View popup
    Table 5.

    Comparison of Suicidal Ideation from EPDS and PHQ-9

    EPDS “The thought of harming myself has occurred to me”PHQ-9 “Thoughts that you would be better off dead, or of hurting yourself in some way”
    Not at AllSeveral DaysMore Than Half the DaysNearly Every Day
    Never4351010
    Hardly ever121000
    Sometimes3540
    Often0001
    • EPDS, Edinburgh Postnatal Depression Scale; PHQ, Patient Health Questionnaire.

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The Journal of the American Board of Family Medicine: 22 (5)
The Journal of the American Board of Family Medicine
Vol. 22, Issue 5
September-October 2009
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Concordance of Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) to Assess Increased Risk of Depression among Postpartum Women
Barbara P. Yawn, Wilson Pace, Peter C. Wollan, Susan Bertram, Margary Kurland, Deborah Graham, Allen Dietrich
The Journal of the American Board of Family Medicine Sep 2009, 22 (5) 483-491; DOI: 10.3122/jabfm.2009.05.080155

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Concordance of Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) to Assess Increased Risk of Depression among Postpartum Women
Barbara P. Yawn, Wilson Pace, Peter C. Wollan, Susan Bertram, Margary Kurland, Deborah Graham, Allen Dietrich
The Journal of the American Board of Family Medicine Sep 2009, 22 (5) 483-491; DOI: 10.3122/jabfm.2009.05.080155
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