Sensitivity and Specificity of the Edinburgh Postnatal Depression Scale (EPDS) among Iranian Mothers: A Psychometric Study


1 Kowsar Hospital, Department of Gynecology and Obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Psychiatrist, Research Center for Addiction and Risky Behaviors (ReCARB), Iran University of Medical Sciences, Tehran, Iran.

3 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran .

5 Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.

6 Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

7 Department of Educational Psychology, Ferdowsi University of Mashhad, Iran.


Objective: There is few psychometric study addressed to sensitivity and specificity of Persian version of the Edinburgh Postnatal Depression Scale (EPDS). Therefore, there is need to future studies to identify best cut-off point for EPDS score. The present study aimed to assess the validity of the EPDS among Iranian mothers.
Material and methods: The study is a secondary analysis on a descriptive correlational design to evaluate the sensitivity and the specificity of the Persian version of EPDS. The study conducted in Mashhad, Iran among 200 postpartum women attending for routine post-natal at six health service centers selected through stratified sampling method, and mothers filled EPDS tool. Statistical analyses were performed using SPSS software version 16.0. The sensitivity and specificity of the EPDS assessed according to the gold standard DSM-IV criteria for depression with Receiver operating characteristic (ROC) curves using MedCalc statistical software (version 13.0).

Results: 30% of mothers were depression based on Edinburgh scale. The best cut-off point to discriminate mothers with depression (a combination major and minor depression) from normal women in postpartum period was >10 with sensitivity 87.95% and specificity 93.86%. The highest area under the receiver operating characteristic curve (ROC= 0.959). For women with major depression, the best cut-off point was 16 with sensitivity 94.12% and specificity 94.54% (ROC= 0.98).
Conclusions: In conclusion, the finding of this psychometric study showed the Persian version of EPDS can be used as valid tool at a cut-off score of >10 to screen mothers with a combination major and minor depression and at cut-off score of >16 for screening those with major depression in postpartum period in health care center.