The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy

Research output: Contribution to journalReview article


Background: Around 1015% of women suffer from depressive illness during pregnancy or the first year postpartum. Depression during pregnancy constitutes a risk for prenatal stress and preterm birth. No validated screening instrument for detecting depression during pregnancy was available in Swedish. Aims: We aimed to validate the Edinburgh Postnatal Depression Scale (EPDS) against DSM-IV criteria for depression during pregnancy, establish a reliable cut-off and estimate the correlation between the EPDS and HAD-S (Hospital Anxiety and Depression Scale). Methods: In a population-based community sample of 1175 pregnant women, 918 women (78%) answered questionnaires with the EPDS and HAD-S. In all, 121 were interviewed using the PRIME-MD (Primary Care Evaluation of Mental disorders) for diagnosing depression. Women were interviewed in mean gestational week 13 (range 821). For the EPDS, a receiver operating characteristic (ROC) curve was calculated for prediction of depression. Pearson's correlation coefficient was used to investigate the association between EPDS and HAD-S scores. Results: The optimal cut-off score on the EPDS scale for detecting depression was ≥13 (standard error coefficient of 1.09 and c-statistics of 0.84) giving a sensitivity of 77% and specificity of 94%. The EPDS scores correlated strongly with the HAD-S, Pearson's correlation was 0.83 (P < 0.0001). Conclusions: This study confirms that the EPDS is a valid screening instrument for detection of depressive symptoms during pregnancy. The EPDS shows persuasive measuring outcomes with an optimal cut-off at ≥13. Clinical implications: Healthcare for pregnant women should consider screening procedures and follow-up routines for depressive symptoms.


External organisations
  • Uppsala University
  • Karolinska University Hospital
  • Västmanland Hospital
  • Linköping University
Research areas and keywords


  • Antepartum, Depression, EPDS, Pregnancy, Screening
Original languageEnglish
Pages (from-to)414-418
Number of pages5
JournalNordic Journal of Psychiatry
Issue number6
Publication statusPublished - 2011 Dec
Publication categoryResearch
Externally publishedYes