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Arch Womens Ment Health (2010) 13:515522 DOI 10.1007/s00737-010-0170-6
ORIGINAL ARTICLE
Using the Edinburgh postnatal depression scale to screen for perinatal anxiety
Delphin Swalm & Janette Brooks & Dorota Doherty &
Elizabeth Nathan & Angela Jacques
Received: 19 October 2009 /Accepted: 9 June 2010 /Published online: 24 June 2010 # Springer-Verlag 2010
Abstract We replicated the factor structure of the anxiety subscale of the Edinburgh Postnatal Depression Scale (EPDS) in a large convenience sample of Western Australian women who participated in the beyondblue National Postnatal Depression Program. In addition, we determined an appropriate cut-off score for the anxiety subscale. Factor analyses conducted on the EPDS responses yielded depression and anxiety factors as identified in previous research. Two-factor solutions accounted for over 50% of the variance at two time frames: antenatally (N=4,706) and at postnatal follow-up (N=3,853). The anxiety and depression factors had similar factor structures antenatally and postnatally and
were consistent with previous published findings. The concurrent validity of the anxiety subscale was demonstrated by its significant relationship to anxiety-related items on a psychosocial risk factors questionnaire. Anxiety dropped significantly from the antenatal to the postnatal time period. These findings confirm the anxiety subscale of the EPDS and point to its utility in screening for anxiety symptoms using a cut-off score 4 which captured the top quartile of the antenatal sample.
Keywords Perinatal depression/anxiety. Psychosocial screening . Pregnancy . Perinatal mental health
Introduction
One in five Australian mothers of full-term infants suffers from a perinatal mental health disorder within the first year of birth (Priest et al. 2005), yet many are not diagnosed or treated (Buist et al. 2005). Evans et al. (Evans et al. 2001) found that more symptoms were identified on the Edinburgh Postnatal Depression Scale (EPDS, Cox et al. 1987) antenatally than postnatally, broadening the focus from postnatal to perinatal depression. Antenatal anxiety and depression occur frequently, often together (OConnor et al. 2002a), and may lead to postnatal depression and anxiety (Heron et al. 2004). Canadian research has shown that postnatal disorders are persistent: just over half of the female and male subjects who were diagnosed with a psychiatric disorder at 2 months after childbirth remained so at 6 months postpartum (Zelkowitz and Milet 2001).
A growing body of research suggests that anxiety...