A Systematic Review of Psychometric Properties of the Edinburgh Postnatal Depression Scale in Iranian Population

Background: Regarding adverse effects of postpartum depression on maternal mental health and the reduction of mother-infant attachment, there is a need to comprehensively understand Edinburgh Postnatal Depression Scale (EPDS). We aimed to review the validity and reliability of the EPDS in Iranian population to provide comprehensive information for the health providers. Materials and Methods The search procedure was fulfilled on the databases of Medline (via PubMed), Scopus, Cochran Library and Web of Science from inception to April 2018. The quality of studies was assessed by COSMIN checklist. Search keywords include (Edinburgh Postnatal Depression Scale) AND (Psychometric Properties). Results: Three studies identified a two-factor structure and one study found a three-factor structure. Discriminant validity of the EPDS was able to differentiate three groups (minor depression, major depression, and healthy women); but failed to distinguish between women with caesarean section, and women with normal delivery. Internal consistency was reported by four studies. Cronbach's alpha ranged from 0.7 to 0.79 for total EPDS score. Test-retest reliability was reported only in a study with Intraclass Correlation Coefficient (ICC) > 0.80. In terms of convergent validity, the EPDS was significantly positively correlated with General Health Questionnaire (GHQ) (r=0.76; p<0.001), and Hamilton Depression Rating Scale (HDRS) (r=0.62, p<0.001), and negatively with Short Form Health Survey (SF-36). Sensitivity was almost 0.74%, and specificity ranged from 0.80% to 0.93% at the cutoff point of <12. Conclusion Evidence to support the validity and reliability of the EPDS in Iranian population is sufficient as a screening tool for postnatal depression to decrease damage to the mother and the baby.