Overestimation of postpartum depression prevalence based on a 5-item version of the EPDS: systematic review and individual participant data meta-analysis

The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Canadian Institutes of Health Research (CIHR, KRS-140994). Drs. Thombs and Benedetti were supported by Fonds de recherche du Qu´ebec–Sant´e (FRQS) researcher salary awards. Dr. Levis was supported by a FRQS Postdoctoral Training Fellowship. Ms. Lyubenova was supported by theMitacs Globalink Research Internship Program. Ms. Neupane was supported by G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University. Dr. Wu was supported by a FRQS Postdoctoral Training Fellowship. Ms. Rice was supported by a Vanier Canada Graduate Scholarship. Mr. Bhandari was supported by a studentship from the Research Institute of the McGill University Health Centre. 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 de Figueiredo et al. was supported by Fundacão de Amparo à Pesquisa do Estado de São Paulo. 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 Helle et al. was supported by the Werner Otto Foundation, the Kroschke Foundation, and the Feindt Foundation. 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 RPPG-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 Nakic´ Radoˇs et al. was supported by the Croatian Ministry of Science, Education, and Sports (134-0000000-2421). The primary study by Quispel et al. was supported by Stichting Achmea Gezondheid (grant number z-282). 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 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 Vega-Dienstmaier et al. was supported by Tejada Family Foundation, Inc, and Peruvian-American Endowment, Inc. No other authors reported funding for primary studies or for their work on this study.