Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis

Anita Lyubenova; Dipika Neupane; Brooke Levis; Yin Wu; Ying Sun; Chen He; Ankur Krishnan; Parash M. Bhandari; Zelalem Negeri; Mahrukh Imran; Danielle B. Rice; Marleine Azar; Matthew J. Chiovitti; Nazanin Saadat; Kira E. Riehm; Jill T. Boruff; John P.A. Ioannidis; Pim Cuijpers; Simon Gilbody; Lorie A. Kloda; Scott B. Patten; Ian Shrier; Roy C. Ziegelstein; Liane Comeau; Nicholas D. Mitchell; Marcello Tonelli; Simone N. Vigod; Franca Aceti; Jacqueline Barnes; Amar D. Bavle; Cheryl T. Beck; Carola Bindt; Philip M. Boyce; Adomas Bunevicius; Linda H. Chaudron; Nicolas Favez; Barbara Figueiredo; Lluïsa Garcia-Esteve; Lisa Giardinelli; Nadine Helle; Louise M. Howard; Jane Kohlhoff; Laima Kusminskas; Zoltán Kozinszky; Lorenzo Lelli; Angeliki A. Leonardou; Valentina Meuti; Sandra N. Radoš; Purificación N. García; Susan J. Pawlby; Chantal Quispel; Emma Robertson-Blackmore; Tamsen J. Rochat; Deborah J. Sharp; Bonnie W.M. Siu; Alan Stein; Robert C. Stewart; Meri Tadinac; S. Darius Tandon; Iva Tendais; Annamária Töreki; Anna Torres-Giménez; Thach D. Tran; Kylee Trevillion; Katherine Turner; Johann M. Vega-Dienstmaier; Andrea Benedetti; Brett D. Thombs

doi:10.1002/mpr.1860

Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis

Anita Lyubenova, Dipika Neupane, Brooke Levis, Yin Wu, Ying Sun, Chen He, Ankur Krishnan, Parash M. Bhandari, Zelalem Negeri, Mahrukh Imran, Danielle B. Rice, Marleine Azar, Matthew J. Chiovitti, Nazanin Saadat, Kira E. Riehm, Jill T. Boruff, John P.A. Ioannidis, Pim Cuijpers, Simon Gilbody, Lorie A. KlodaScott B. Patten, Ian Shrier, Roy C. Ziegelstein, Liane Comeau, Nicholas D. Mitchell, Marcello Tonelli, Simone N. Vigod, Franca Aceti, Jacqueline Barnes, Amar D. Bavle, Cheryl T. Beck, Carola Bindt, Philip M. Boyce, Adomas Bunevicius, Linda H. Chaudron, Nicolas Favez, Barbara Figueiredo, Lluïsa Garcia-Esteve, Lisa Giardinelli, Nadine Helle, Louise M. Howard, Jane Kohlhoff, Laima Kusminskas, Zoltán Kozinszky, Lorenzo Lelli, Angeliki A. Leonardou, Valentina Meuti, Sandra N. Radoš, Purificación N. García, Susan J. Pawlby, Chantal Quispel, Emma Robertson-Blackmore, Tamsen J. Rochat, Deborah J. Sharp, Bonnie W.M. Siu, Alan Stein, Robert C. Stewart, Meri Tadinac, S. Darius Tandon, Iva Tendais, Annamária Töreki, Anna Torres-Giménez, Thach D. Tran, Kylee Trevillion, Katherine Turner, Johann M. Vega-Dienstmaier, Andrea Benedetti, Brett D. Thombs^*

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Objectives: Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. Methods: We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. Results: Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%–34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%–11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%–12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: −13.7%, 12.3%). Conclusion: EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.

Original language	English
Article number	e1860
Pages (from-to)	1-13
Number of pages	13
Journal	International Journal of Methods in Psychiatric Research
Volume	30
Issue number	1
Early online date	22 Oct 2020
DOIs	https://doi.org/10.1002/mpr.1860
Publication status	Published - Mar 2021

Bibliographical note

Funding Information:
This study was funded by the Canadian Institutes of Health Research (CIHR, KRS‐140994). Ms. Lyubenova was supported by the Mitacs Globalink Research Internship Program. Ms. Neupane was supported by G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University. Drs. Levis and Wu were supported by Fonds de recherche du Québec‐Santé (FRQS) Postdoctoral Training Fellowships. Mr. Bhandari was supported by a studentship from the Research Institute of the McGill University Health Centre. Ms. Rice was supported by a Vanier Canada Graduate Scholarship. Ms. Azar was supported by a FRQS Masters Training Award. The primary study by Barnes et al. was supported by a grant from the Health Foundation (1665/608). The primary study by Beck et al. was supported by the Patrick and Catherine Weldon Donaghue Medical Research Foundation and the University of Connecticut Research Foundation. The primary study by Helle et al. was supported by the Werner Otto Foundation, the Kroschke Foundation, and the Feindt Foundation. Prof. Robertas Bunevicius, MD, PhD (1958‐2016) was Principal Investigator of the primary study by Bunevicius et al., but passed away and was unable to participate in this project. The primary study by Chaudron et al. was supported by a grant from the National Institute of Mental Health (grant K23 MH64476). The primary study by Tissot et al. was supported by the Swiss National Science Foundation (grant 32003B 125493). The primary study by Tendais et al. was supported under the project POCI/SAU‐ESP/56397/2004 by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III and by the European Community Fund FEDER. The primary study by Garcia‐Esteve et al. was supported by grant 7/98 from the Ministerio de Trabajo y Asuntos Sociales, Women's Institute, Spain. The primary study by Howard et al. was supported by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Numbers RP‐PG‐1210‐12002 and RP‐DG‐1108‐10012) and by the South London Clinical Research Network. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The primary study by Phillips et al. was supported by a scholarship from the National Health and Medical and Research Council (NHMRC). The primary study by Nakić Radoš et al. was supported by the Croatian Ministry of Science, Education, and Sports (134‐0000000‐2421). The primary study by Navarro et al. was supported by grant 13/00 from the Ministry of Work and Social Affairs, Institute of Women, Spain. The primary study by Pawlby et al. was supported by a Medical Research Council UK Project Grant (number G89292999N). The primary study by Quispel et al. was supported by Stichting Achmea Gezondheid (grant number z‐282). Dr. Robertson‐Blackmore was supported by a Young Investigator Award from the Brain and Behavior Research Foundation and NIMH grant K23MH080290. The primary study by Rochat et al. was supported by grants from the University of Oxford (HQ5035), the Tuixen Foundation (9940), the Wellcome Trust (082384/Z/07/Z and 071571), and the American Psychological Association. Dr. Rochat receives salary support from a Wellcome Trust Intermediate Fellowship (211374/Z/18/Z). The primary study by Prenoveau et al. was supported by The Wellcome Trust (grant number 071571). The primary study by Stewart et al. was supported by Professor Francis Creed's Journal of Psychosomatic Research Editorship fund (BA00457) administered through University of Manchester. The primary study by Tandon et al. was funded by the Thomas Wilson Sanitarium. The primary study by Tran et al. was supported by the Myer Foundation who funded the study under its Beyond Australia scheme. Dr. Tran was supported by an early career fellowship from the Australian National Health and Medical Research Council. The primary study by Vega‐Dienstmaier et al. was supported by Tejada Family Foundation, Inc, and Peruvian‐American Endowment, Inc. Drs. Benedetti and Thombs were supported by FRQS researcher salary awards.

Publisher Copyright:
© 2020 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Funding

This study was funded by the Canadian Institutes of Health Research (CIHR, KRS‐140994). Ms. Lyubenova was supported by the Mitacs Globalink Research Internship Program. Ms. Neupane was supported by G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University. Drs. Levis and Wu were supported by Fonds de recherche du Québec‐Santé (FRQS) Postdoctoral Training Fellowships. Mr. Bhandari was supported by a studentship from the Research Institute of the McGill University Health Centre. Ms. Rice was supported by a Vanier Canada Graduate Scholarship. Ms. Azar was supported by a FRQS Masters Training Award. The primary study by Barnes et al. was supported by a grant from the Health Foundation (1665/608). The primary study by Beck et al. was supported by the Patrick and Catherine Weldon Donaghue Medical Research Foundation and the University of Connecticut Research Foundation. The primary study by Helle et al. was supported by the Werner Otto Foundation, the Kroschke Foundation, and the Feindt Foundation. Prof. Robertas Bunevicius, MD, PhD (1958‐2016) was Principal Investigator of the primary study by Bunevicius et al., but passed away and was unable to participate in this project. The primary study by Chaudron et al. was supported by a grant from the National Institute of Mental Health (grant K23 MH64476). The primary study by Tissot et al. was supported by the Swiss National Science Foundation (grant 32003B 125493). The primary study by Tendais et al. was supported under the project POCI/SAU‐ESP/56397/2004 by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III and by the European Community Fund FEDER. The primary study by Garcia‐Esteve et al. was supported by grant 7/98 from the Ministerio de Trabajo y Asuntos Sociales, Women's Institute, Spain. The primary study by Howard et al. was supported by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Numbers RP‐PG‐1210‐12002 and RP‐DG‐1108‐10012) and by the South London Clinical Research Network. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The primary study by Phillips et al. was supported by a scholarship from the National Health and Medical and Research Council (NHMRC). The primary study by Nakić Radoš et al. was supported by the Croatian Ministry of Science, Education, and Sports (134‐0000000‐2421). The primary study by Navarro et al. was supported by grant 13/00 from the Ministry of Work and Social Affairs, Institute of Women, Spain. The primary study by Pawlby et al. was supported by a Medical Research Council UK Project Grant (number G89292999N). The primary study by Quispel et al. was supported by Stichting Achmea Gezondheid (grant number z‐282). Dr. Robertson‐Blackmore was supported by a Young Investigator Award from the Brain and Behavior Research Foundation and NIMH grant K23MH080290. The primary study by Rochat et al. was supported by grants from the University of Oxford (HQ5035), the Tuixen Foundation (9940), the Wellcome Trust (082384/Z/07/Z and 071571), and the American Psychological Association. Dr. Rochat receives salary support from a Wellcome Trust Intermediate Fellowship (211374/Z/18/Z). The primary study by Prenoveau et al. was supported by The Wellcome Trust (grant number 071571). The primary study by Stewart et al. was supported by Professor Francis Creed's Journal of Psychosomatic Research Editorship fund (BA00457) administered through University of Manchester. The primary study by Tandon et al. was funded by the Thomas Wilson Sanitarium. The primary study by Tran et al. was supported by the Myer Foundation who funded the study under its Beyond Australia scheme. Dr. Tran was supported by an early career fellowship from the Australian National Health and Medical Research Council. The primary study by Vega‐Dienstmaier et al. was supported by Tejada Family Foundation, Inc, and Peruvian‐American Endowment, Inc. Drs. Benedetti and Thombs were supported by FRQS researcher salary awards.

Funders	Funder number
Community Support Board III
Croatian Ministry of Science, Education, and Sports	134‐0000000‐2421, 13/00
European Community Fund FEDER	7/98
Feindt Foundation
Kroschke Foundation
Ministerio de Trabajo y Asuntos Sociales
Ministry of Work and Social Affairs, Institute of Women, Spain
Stichting Achmea Gezondheid	z‐282
Tejada Family Foundation
Thomas Wilson Sanitarium
Tuixen Foundation	9940
Vanier Canada Graduate Scholarship
Women's Institute
National Institute of Mental Health	K23MH080290, K23MH064476
Brain and Behavior Research Foundation
Patrick and Catherine Weldon Donaghue Medical Research Foundation
American Psychological Association	BA00457, 211374/Z/18/Z
University of Connecticut
McGill University
Wellcome Trust	071571, 082384/Z/07/Z
McGill University Health Centre
Canadian Institutes of Health Research	KRS‐140994
Fonds de Recherche du Québec - Santé
Medical Research Council	G89292999N
National Institute for Health Research	RP‐PG‐1210‐12002, RP‐DG‐1108‐10012
Health Foundation	1665/608
University of Oxford	HQ5035
University of Manchester
National Health and Medical Research Council
Myer Foundation
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung	POCI/SAU‐ESP/56397/2004, 32003B 125493
Mitacs
Werner Otto Stiftung

Keywords

depression prevalence
Edinburgh Postnatal Depression Scale
individual participant data meta-analysis
major depression
structured clinical interview for DSM

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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Lyubenova, A., Neupane, D., Levis, B., Wu, Y., Sun, Y., He, C., Krishnan, A., Bhandari, P. M., Negeri, Z., Imran, M., Rice, D. B., Azar, M., Chiovitti, M. J., Saadat, N., Riehm, K. E., Boruff, J. T., Ioannidis, J. P. A., Cuijpers, P., Gilbody, S., ... Thombs, B. D. (2021). Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis. International Journal of Methods in Psychiatric Research, 30(1), 1-13. Article e1860. https://doi.org/10.1002/mpr.1860

@article{6f8ff1ca3dcc496795785756dc296aaa,

title = "Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis",

abstract = "Objectives: Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. Methods: We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. Results: Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%–34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%–11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%–12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: −13.7%, 12.3%). Conclusion: EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.",

keywords = "depression prevalence, Edinburgh Postnatal Depression Scale, individual participant data meta-analysis, major depression, structured clinical interview for DSM",

author = "Anita Lyubenova and Dipika Neupane and Brooke Levis and Yin Wu and Ying Sun and Chen He and Ankur Krishnan and Bhandari, {Parash M.} and Zelalem Negeri and Mahrukh Imran and Rice, {Danielle B.} and Marleine Azar and Chiovitti, {Matthew J.} and Nazanin Saadat and Riehm, {Kira E.} and Boruff, {Jill T.} and Ioannidis, {John P.A.} and Pim Cuijpers and Simon Gilbody and Kloda, {Lorie A.} and Patten, {Scott B.} and Ian Shrier and Ziegelstein, {Roy C.} and Liane Comeau and Mitchell, {Nicholas D.} and Marcello Tonelli and Vigod, {Simone N.} and Franca Aceti and Jacqueline Barnes and Bavle, {Amar D.} and Beck, {Cheryl T.} and Carola Bindt and Boyce, {Philip M.} and Adomas Bunevicius and Chaudron, {Linda H.} and Nicolas Favez and Barbara Figueiredo and Llu{\"i}sa Garcia-Esteve and Lisa Giardinelli and Nadine Helle and Howard, {Louise M.} and Jane Kohlhoff and Laima Kusminskas and Zolt{\'a}n Kozinszky and Lorenzo Lelli and Leonardou, {Angeliki A.} and Valentina Meuti and Rado{\v s}, {Sandra N.} and Garc{\'i}a, {Purificaci{\'o}n N.} and Pawlby, {Susan J.} and Chantal Quispel and Emma Robertson-Blackmore and Rochat, {Tamsen J.} and Sharp, {Deborah J.} and Siu, {Bonnie W.M.} and Alan Stein and Stewart, {Robert C.} and Meri Tadinac and Tandon, {S. Darius} and Iva Tendais and Annam{\'a}ria T{\"o}reki and Anna Torres-Gim{\'e}nez and Tran, {Thach D.} and Kylee Trevillion and Katherine Turner and Vega-Dienstmaier, {Johann M.} and Andrea Benedetti and Thombs, {Brett D.}",

note = "Funding Information: This study was funded by the Canadian Institutes of Health Research (CIHR, KRS‐140994). Ms. Lyubenova was supported by the Mitacs Globalink Research Internship Program. Ms. Neupane was supported by G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University. Drs. Levis and Wu were supported by Fonds de recherche du Qu{\'e}bec‐Sant{\'e} (FRQS) Postdoctoral Training Fellowships. Mr. Bhandari was supported by a studentship from the Research Institute of the McGill University Health Centre. Ms. Rice was supported by a Vanier Canada Graduate Scholarship. Ms. Azar was supported by a FRQS Masters Training Award. The primary study by Barnes et al. was supported by a grant from the Health Foundation (1665/608). The primary study by Beck et al. was supported by the Patrick and Catherine Weldon Donaghue Medical Research Foundation and the University of Connecticut Research Foundation. The primary study by Helle et al. was supported by the Werner Otto Foundation, the Kroschke Foundation, and the Feindt Foundation. Prof. Robertas Bunevicius, MD, PhD (1958‐2016) was Principal Investigator of the primary study by Bunevicius et al., but passed away and was unable to participate in this project. The primary study by Chaudron et al. was supported by a grant from the National Institute of Mental Health (grant K23 MH64476). The primary study by Tissot et al. was supported by the Swiss National Science Foundation (grant 32003B 125493). The primary study by Tendais et al. was supported under the project POCI/SAU‐ESP/56397/2004 by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III and by the European Community Fund FEDER. The primary study by Garcia‐Esteve et al. was supported by grant 7/98 from the Ministerio de Trabajo y Asuntos Sociales, Women's Institute, Spain. The primary study by Howard et al. was supported by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Numbers RP‐PG‐1210‐12002 and RP‐DG‐1108‐10012) and by the South London Clinical Research Network. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The primary study by Phillips et al. was supported by a scholarship from the National Health and Medical and Research Council (NHMRC). The primary study by Naki{\'c} Rado{\v s} et al. was supported by the Croatian Ministry of Science, Education, and Sports (134‐0000000‐2421). The primary study by Navarro et al. was supported by grant 13/00 from the Ministry of Work and Social Affairs, Institute of Women, Spain. The primary study by Pawlby et al. was supported by a Medical Research Council UK Project Grant (number G89292999N). The primary study by Quispel et al. was supported by Stichting Achmea Gezondheid (grant number z‐282). Dr. Robertson‐Blackmore was supported by a Young Investigator Award from the Brain and Behavior Research Foundation and NIMH grant K23MH080290. The primary study by Rochat et al. was supported by grants from the University of Oxford (HQ5035), the Tuixen Foundation (9940), the Wellcome Trust (082384/Z/07/Z and 071571), and the American Psychological Association. Dr. Rochat receives salary support from a Wellcome Trust Intermediate Fellowship (211374/Z/18/Z). The primary study by Prenoveau et al. was supported by The Wellcome Trust (grant number 071571). The primary study by Stewart et al. was supported by Professor Francis Creed's Journal of Psychosomatic Research Editorship fund (BA00457) administered through University of Manchester. The primary study by Tandon et al. was funded by the Thomas Wilson Sanitarium. The primary study by Tran et al. was supported by the Myer Foundation who funded the study under its Beyond Australia scheme. Dr. Tran was supported by an early career fellowship from the Australian National Health and Medical Research Council. The primary study by Vega‐Dienstmaier et al. was supported by Tejada Family Foundation, Inc, and Peruvian‐American Endowment, Inc. Drs. Benedetti and Thombs were supported by FRQS researcher salary awards. Publisher Copyright: {\textcopyright} 2020 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = mar,

doi = "10.1002/mpr.1860",

language = "English",

volume = "30",

pages = "1--13",

journal = "International Journal of Methods in Psychiatric Research",

issn = "1049-8931",

publisher = "Wiley-Blackwell",

number = "1",

}

Lyubenova, A, Neupane, D, Levis, B, Wu, Y, Sun, Y, He, C, Krishnan, A, Bhandari, PM, Negeri, Z, Imran, M, Rice, DB, Azar, M, Chiovitti, MJ, Saadat, N, Riehm, KE, Boruff, JT, Ioannidis, JPA, Cuijpers, P, Gilbody, S, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Comeau, L, Mitchell, ND, Tonelli, M, Vigod, SN, Aceti, F, Barnes, J, Bavle, AD, Beck, CT, Bindt, C, Boyce, PM, Bunevicius, A, Chaudron, LH, Favez, N, Figueiredo, B, Garcia-Esteve, L, Giardinelli, L, Helle, N, Howard, LM, Kohlhoff, J, Kusminskas, L, Kozinszky, Z, Lelli, L, Leonardou, AA, Meuti, V, Radoš, SN, García, PN, Pawlby, SJ, Quispel, C, Robertson-Blackmore, E, Rochat, TJ, Sharp, DJ, Siu, BWM, Stein, A, Stewart, RC, Tadinac, M, Tandon, SD, Tendais, I, Töreki, A, Torres-Giménez, A, Tran, TD, Trevillion, K, Turner, K, Vega-Dienstmaier, JM, Benedetti, A & Thombs, BD 2021, 'Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis', International Journal of Methods in Psychiatric Research, vol. 30, no. 1, e1860, pp. 1-13. https://doi.org/10.1002/mpr.1860

Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis. / Lyubenova, Anita; Neupane, Dipika; Levis, Brooke et al.
In: International Journal of Methods in Psychiatric Research, Vol. 30, No. 1, e1860, 03.2021, p. 1-13.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification

T2 - Systematic review and individual participant data meta-analysis

AU - Lyubenova, Anita

AU - Neupane, Dipika

AU - Levis, Brooke

AU - Wu, Yin

AU - Sun, Ying

AU - He, Chen

AU - Krishnan, Ankur

AU - Bhandari, Parash M.

AU - Negeri, Zelalem

AU - Imran, Mahrukh

AU - Rice, Danielle B.

AU - Azar, Marleine

AU - Chiovitti, Matthew J.

AU - Saadat, Nazanin

AU - Riehm, Kira E.

AU - Boruff, Jill T.

AU - Ioannidis, John P.A.

AU - Cuijpers, Pim

AU - Gilbody, Simon

AU - Kloda, Lorie A.

AU - Patten, Scott B.

AU - Shrier, Ian

AU - Ziegelstein, Roy C.

AU - Comeau, Liane

AU - Mitchell, Nicholas D.

AU - Tonelli, Marcello

AU - Vigod, Simone N.

AU - Aceti, Franca

AU - Barnes, Jacqueline

AU - Bavle, Amar D.

AU - Beck, Cheryl T.

AU - Bindt, Carola

AU - Boyce, Philip M.

AU - Bunevicius, Adomas

AU - Chaudron, Linda H.

AU - Favez, Nicolas

AU - Figueiredo, Barbara

AU - Garcia-Esteve, Lluïsa

AU - Giardinelli, Lisa

AU - Helle, Nadine

AU - Howard, Louise M.

AU - Kohlhoff, Jane

AU - Kusminskas, Laima

AU - Kozinszky, Zoltán

AU - Lelli, Lorenzo

AU - Leonardou, Angeliki A.

AU - Meuti, Valentina

AU - Radoš, Sandra N.

AU - García, Purificación N.

AU - Pawlby, Susan J.

AU - Quispel, Chantal

AU - Robertson-Blackmore, Emma

AU - Rochat, Tamsen J.

AU - Sharp, Deborah J.

AU - Siu, Bonnie W.M.

AU - Stein, Alan

AU - Stewart, Robert C.

AU - Tadinac, Meri

AU - Tandon, S. Darius

AU - Tendais, Iva

AU - Töreki, Annamária

AU - Torres-Giménez, Anna

AU - Tran, Thach D.

AU - Trevillion, Kylee

AU - Turner, Katherine

AU - Vega-Dienstmaier, Johann M.

AU - Benedetti, Andrea

AU - Thombs, Brett D.

N1 - Funding Information: This study was funded by the Canadian Institutes of Health Research (CIHR, KRS‐140994). Ms. Lyubenova was supported by the Mitacs Globalink Research Internship Program. Ms. Neupane was supported by G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University. Drs. Levis and Wu were supported by Fonds de recherche du Québec‐Santé (FRQS) Postdoctoral Training Fellowships. Mr. Bhandari was supported by a studentship from the Research Institute of the McGill University Health Centre. Ms. Rice was supported by a Vanier Canada Graduate Scholarship. Ms. Azar was supported by a FRQS Masters Training Award. The primary study by Barnes et al. was supported by a grant from the Health Foundation (1665/608). The primary study by Beck et al. was supported by the Patrick and Catherine Weldon Donaghue Medical Research Foundation and the University of Connecticut Research Foundation. The primary study by Helle et al. was supported by the Werner Otto Foundation, the Kroschke Foundation, and the Feindt Foundation. Prof. Robertas Bunevicius, MD, PhD (1958‐2016) was Principal Investigator of the primary study by Bunevicius et al., but passed away and was unable to participate in this project. The primary study by Chaudron et al. was supported by a grant from the National Institute of Mental Health (grant K23 MH64476). The primary study by Tissot et al. was supported by the Swiss National Science Foundation (grant 32003B 125493). The primary study by Tendais et al. was supported under the project POCI/SAU‐ESP/56397/2004 by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III and by the European Community Fund FEDER. The primary study by Garcia‐Esteve et al. was supported by grant 7/98 from the Ministerio de Trabajo y Asuntos Sociales, Women's Institute, Spain. The primary study by Howard et al. was supported by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Numbers RP‐PG‐1210‐12002 and RP‐DG‐1108‐10012) and by the South London Clinical Research Network. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The primary study by Phillips et al. was supported by a scholarship from the National Health and Medical and Research Council (NHMRC). The primary study by Nakić Radoš et al. was supported by the Croatian Ministry of Science, Education, and Sports (134‐0000000‐2421). The primary study by Navarro et al. was supported by grant 13/00 from the Ministry of Work and Social Affairs, Institute of Women, Spain. The primary study by Pawlby et al. was supported by a Medical Research Council UK Project Grant (number G89292999N). The primary study by Quispel et al. was supported by Stichting Achmea Gezondheid (grant number z‐282). Dr. Robertson‐Blackmore was supported by a Young Investigator Award from the Brain and Behavior Research Foundation and NIMH grant K23MH080290. The primary study by Rochat et al. was supported by grants from the University of Oxford (HQ5035), the Tuixen Foundation (9940), the Wellcome Trust (082384/Z/07/Z and 071571), and the American Psychological Association. Dr. Rochat receives salary support from a Wellcome Trust Intermediate Fellowship (211374/Z/18/Z). The primary study by Prenoveau et al. was supported by The Wellcome Trust (grant number 071571). The primary study by Stewart et al. was supported by Professor Francis Creed's Journal of Psychosomatic Research Editorship fund (BA00457) administered through University of Manchester. The primary study by Tandon et al. was funded by the Thomas Wilson Sanitarium. The primary study by Tran et al. was supported by the Myer Foundation who funded the study under its Beyond Australia scheme. Dr. Tran was supported by an early career fellowship from the Australian National Health and Medical Research Council. The primary study by Vega‐Dienstmaier et al. was supported by Tejada Family Foundation, Inc, and Peruvian‐American Endowment, Inc. Drs. Benedetti and Thombs were supported by FRQS researcher salary awards. Publisher Copyright: © 2020 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/3

Y1 - 2021/3

N2 - Objectives: Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. Methods: We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. Results: Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%–34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%–11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%–12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: −13.7%, 12.3%). Conclusion: EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.

AB - Objectives: Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. Methods: We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. Results: Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%–34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%–11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%–12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: −13.7%, 12.3%). Conclusion: EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.

KW - depression prevalence

KW - Edinburgh Postnatal Depression Scale

KW - individual participant data meta-analysis

KW - major depression

KW - structured clinical interview for DSM

UR - http://www.scopus.com/inward/record.url?scp=85093513174&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85093513174&partnerID=8YFLogxK

U2 - 10.1002/mpr.1860

DO - 10.1002/mpr.1860

M3 - Article

AN - SCOPUS:85093513174

SN - 1049-8931

VL - 30

SP - 1

EP - 13

JO - International Journal of Methods in Psychiatric Research

JF - International Journal of Methods in Psychiatric Research

IS - 1

M1 - e1860

ER -

Lyubenova A, Neupane D, Levis B, Wu Y, Sun Y, He C et al. Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis. International Journal of Methods in Psychiatric Research. 2021 Mar;30(1):1-13. e1860. Epub 2020 Oct 22. doi: 10.1002/mpr.1860

Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis

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