Using the Edinburgh postnatal depression scale to screen for perinatal anxiety

Area of Science:

• Psychiatry
• Perinatal Mental Health
• Psychometrics

Background:

• The Edinburgh Postnatal Depression Scale (EPDS) is widely used but its anxiety subscale requires further validation.
• Postnatal depression and anxiety significantly impact maternal well-being.

Purpose of the Study:

• To replicate the factor structure of the EPDS anxiety subscale.
• To determine a suitable cut-off score for antenatal anxiety screening.
• To assess changes in anxiety from antenatal to postnatal periods.

Main Methods:

• Factor analysis of EPDS responses from a large sample of Western Australian women (N=4,706 antenatal, N=3,853 postnatal).
• Concurrent validity assessed using a psychosocial risk factors questionnaire.
• Comparison of anxiety levels between antenatal and postnatal periods.

Main Results:

• A two-factor solution (depression and anxiety) consistently explained over 50% of the variance.
• The anxiety subscale demonstrated concurrent validity.
• Anxiety levels significantly decreased from antenatal to postnatal follow-up.
• A cut-off score of ≥4 on the anxiety subscale identified the top quartile of antenatal anxiety.

Conclusions:

• The EPDS anxiety subscale's factor structure is confirmed in this population.
• The EPDS anxiety subscale is a valid tool for screening antenatal anxiety.
• A cut-off score of ≥4 is recommended for identifying women at risk of antenatal anxiety.