Screening for Postpartum Depression: Comparison of a Validated Questionnaire with a Directed Interview.

OBJECTIVE: To compare the results of a validated self-completed Edinburgh Postnatal Depression Screen (EPDS) with those of a directed interview in the identification of patients at increased risk for postpartum depression. STUDY DESIGN: All patients undergoing a 6 week postpartum evaluation at a teaching hospital between November 1, 2003 and March 31, 2004, were screened for postpartum depression using the self-completed EPDS. This was followed by a directed interview by a social worker blinded to the results of the self-completed EPDS. The social worker verbally administered the EPDS. A positive screen was defined as a score >11 by either method. The number of patients with a positive response to either the EPDS or the directed interview, or both, were recorded. The 2 techniques were compared by the McNemar chi square test. Group demographics and characteristics examined included maternal age, parity, estimated gestational age of delivery, education, cesarean delivery and breast feeding. RESULTS: Among the 134 patients evaluated, a total of 19 (14%) screened positive for increased risk of postpartum depression. The self-completed EPDS and the directed interview detection rates were not different with each identifying 18 (13%) (P = .99) patients at increased risk for postpartum depression. Similiar patients were identified by both techniques with each method detecting an additional patient. The use of the self-completed EPDS and directed interview in parallel detected an additional patient (1%) (P = .99 ). The patient demographics and characteristics between the groups with a positive screen and a negative screen were similiar. CONCLUSION: The EPDS and directed interview are equivalent screening techniques for postpartum depression. There is no evidence to suggest parallel screening improves detection. Either technique should be incorporated into the prenatal and postpartum evaluation of all patients.