Edinburgh Postnatal Depression Scale Spanish: Which Form

Which version you are scoring

Version	Validated in	Reported cut-off	Where to get it
Spain, Garcia-Esteve 2003	Barcelona, 6 weeks postpartum	10/11, major and minor	PubMed record
Mexico, under 4 weeks	Durango, postpartum	11/12	PMC article
Mexico, 4 to 13 weeks	Durango, postpartum	7/8	PMC article
Mexico, pregnancy	Durango, months 2 to 9	9/10, major and minor	Journal article
Peru, Vega-Dienstmaier 2002	Lima, first postpartum year	13.5, major depression	Journal article
Chile, Jadresic 1995	Santiago, middle-class mothers	9/10	PubMed record

A cut written as 10/11 means 11 or higher is the screen-positive side. A cut written as 13.5 means 14 or higher, because the total in front of you is a whole number. Use this table when you are choosing an Edinburgh Postnatal Depression Scale Spanish form. Do not move a cut from one row onto a file from another row.

What each reported cut-off rests on

The rows above are the scan. The numbers below are what you can defend if a colleague asks why 9 is positive on one form and quiet on another.

Spain, Garcia-Esteve 2003

• Version: Spanish EPDS validated by Garcia-Esteve, Ascaso, Ojuel, and Navarro (2003).

• Validated in: 1,201 women at a routine check, 6 weeks postpartum, in Barcelona. A psychiatrist interviewed probable cases and a random sample of lower scores with the SCID-NP for major and minor depression.

• Reported cut-off: 10/11 for combined major and minor depression. Sensitivity 79%, specificity 95.5%, positive predictive value 63.2%, negative predictive value 97.7%. At that cut, every major depression in the interviewed sample was detected. The area under the curve was 0.976.

• Where to get it: The PubMed record. Use the Spanish wording that study tested. Do not keep their 10/11 and swap in a different Spanish file.

Mexico, under 4 weeks

• Version: Spanish translated Mexican EPDS in Alvarado-Esquivel, Sifuentes-Alvarez, Salas-Martinez, and Martínez-García (2006), early postpartum band.

• Validated in: 49 of 100 puerperal women in a public hospital in Durango City, under 4 weeks postpartum. A psychiatrist used DSM-IV criteria. That band had 4 major depressions and no minor depressions. The cut rests on a small case count. Say that when you use it.

• Reported cut-off: 11/12 for screening depression. Sensitivity 75%, specificity 93%, positive predictive value 50%, negative predictive value 97.6%, area under the curve 0.84.

• Where to get it: Additional file 1 on the PMC article. That file is the Mexican wording this study tested. It is not the pregnancy form in the 2014 paper.

Mexico, 4 to 13 weeks

• Version: The same 2006 Mexican EPDS, later postpartum band. Do not reuse the under-4-weeks cut.

• Validated in: 51 women in the same Durango hospital, 4 to 13 weeks postpartum. DSM-IV interview found 7 major depressions and 1 minor depression.

• Reported cut-off: 7/8. Sensitivity 75%, specificity 84%, positive predictive value 46.2%, negative predictive value 94.7%, area under the curve 0.80. A total of 8 or higher is the positive side. A 7 is not.

• Where to get it: The same PMC article and its additional file. The cut changes with weeks. The file does not.

Mexico, pregnancy

• Version: Spanish translated Mexican EPDS for adult pregnant women, Alvarado-Esquivel, Sifuentes-Alvarez, and Salas-Martinez (2014). The paper reports a wording change on item 8, so this is not the postpartum file.

• Validated in: 158 adult women, ages 18 to 45, months 2 to 9 of pregnancy, routine prenatal care in a public hospital in Durango City. DSM-IV criteria found 11 major depressions and 26 minor depressions.

• Reported cut-off: 9/10 for combined major and minor depression. Sensitivity 75.7%, specificity 74.4%, positive predictive value 50.8%, negative predictive value 94.7%. A total of 10 or higher is the positive side.

• Where to get it: The journal article. Do not score the postpartum additional file and then apply this pregnancy cut.

Peru, Vega-Dienstmaier 2002

• Version: Spanish EPDS validated by Vega-Dienstmaier, Mazzotti Suárez, and Campos Sánchez (2002).

• Validated in: 321 Peruvian women within the first year after delivery, interviewed with the SCID section for DSM-IV major depression.

• Reported cut-off: 13.5 for major depression. Sensitivity 84.21%, specificity 79.47%. No woman scoring under 7.5 had major depression. Because you will see a whole-number total, 14 or higher is the positive side of 13.5. Check that table in the paper before you write 13 into a protocol.

• Where to get it: The journal article. Pair this cut only with the wording that study tested.

Chile, Jadresic 1995

• Version: EPDS validated by Jadresic, Araya, and Jara (1995) in Chilean postpartum women.

• Validated in: 108 middle-class mothers at a health care center in Santiago. They filled in the EPDS and were interviewed with the Psychiatric Assessment Schedule. The comparison standard was Research Diagnostic Criteria. Internal consistency was 0.77. Other Chilean investigators found the same 9/10 cut in a sample of working-class women. That second study is not named, so do not add a title you cannot point to.

• Reported cut-off: 9/10. Sensitivity 100%, specificity 80%, positive predictive value 37%. A positive screen here is a reason to interview. It is not a diagnosis. More than half of screen-positive scores in that sample were not cases.

• Where to get it: The PubMed record. Use their cut only with their wording.

How you administer it

An Edinburgh Postnatal Depression Scale Spanish total is only as good as the wording you scored. Ten items, self-report, about 5 minutes, with a simple scoring method: that is the original description in Cox, Holden, and Sagovsky (1987). The English administration sheet from the Black Dog Institute, which cites that paper, asks about the past 7 days. Use the time window printed on the form in your hand. Do not borrow the PHQ-9’s 2-week window because it is familiar.

On that English sheet, items 1, 2, and 4 score 0 on the top response and 3 on the bottom. Items 3 and 5 through 10 are reverse scored, 3 on the top and 0 on the bottom. The total runs from 0 to 30. Confirm the response order on the Spanish file before you assume the English direction still holds. A reversed item scored forward will invent a depression that is not in the room.

The original publication is copyrighted by the Royal College of Psychiatrists, 1987. Permissions for that article go through the publisher’s Rights and Permissions link on the Cambridge Core record. Do not retype items into the note, a handout, or a site.

The Black Dog English sheet may be downloaded from their site only if you leave it unchanged, skip commercial use, and do not host it off their site. That file is English. It is not permission to retype a Spanish form. An EPDS Spanish screenshot from a wellness site, or an Edinburgh depression scale Spanish PDF that names no translator, is not the form these papers tested.

Alvarado and colleagues, citing Cox, Holden, and Sagovsky (1987), report that the original English validation used a threshold of 12/13. That number is not the Spain cut, the Mexico cut, the Peru cut, or the Chile cut. A pooled English-language analysis is a different decision again. If you need the same-appointment action after the score, including who you notify when consent allows, use the perinatal mental health screening workflow. Do not import its instrument choice back onto a Spanish file you have not named.

Item 10 before the client leaves

Score item 10 before the client leaves the chair. On the English sheet, item 10 is the self-harm item. A score of 1, 2, or 3 needs further evaluation before the client leaves, so you can judge the thought and make the referral that keeps the client and the baby safe. A comforting total does not cancel that item.

Do the inquiry in the language the client can answer. If you need an interpreter, say so in the note, and do not treat a partner’s translation as a formal interpreter. A form completed with a partner watching is a different sample than a form completed alone. Write which one you had.

Then follow your practice risk pathway. The screening form flags the event. It does not write the disposition. If the hour has become a safety hour, leave the rest of the form. You can finish a mood total later. You cannot finish a missed item 10 later and call it the same screen.

What you chart

Write Edinburgh Postnatal Depression Scale Spanish in the note only when that is the form you scored, and name the validation. A total without a version is not a result. A colleague who reads “EPDS 9” cannot tell whether you used a Mexico 7/8 cut, a Spain 10/11 cut, or an English 12/13 habit. If you draft the note in AI clinical notes, type the version and the cut yourself; the score belongs to the form you held.

Marisol is 28, six weeks postpartum, and reads Mexican Spanish. She is in your outpatient office, not in the Durango sample. You hold the 2006 additional file, not a clinic bilingual PDF. Six weeks puts her in the 4-to-13-week band, so the reported cut is 7/8, not 11/12.

If her total had been 6 and item 10 had been 1, you would not chart “under the cut” and walk her out. A 1, 2, or 3 on item 10 still needs further evaluation before she leaves. The cut-off does not cancel the item.

Copy the blank stem when the case is not Marisol’s. Fill it in the hour. Do not leave the brackets in the signed note.

Put that line in the session note the same day. The paper form still has to be the form the validation tested. A software field does not create a license you do not hold.

When you stop

Stop the screen when the hour is no longer a form-selection problem.

If item 10 is 1 or higher, or the client names current danger, leave the total. Follow the practice risk pathway. Finish the mood score later, if you finish it at all.

If you do not hold the Spanish file that matches the cut you want to cite, do not photocopy a colleague’s PDF and do not type items from memory. Wait for the file, or use an English form you are allowed to use and name that form. A borrowed scan is not a backup plan.

If the client arrives with a phone quiz total, thank them and do not enter that number as a clinical score. Offer the official file that matches the Spanish they read.

If the client cannot read the Spanish on the form, do not translate the items aloud and call it the same scale. Offer the English form you are allowed to use. Write which language was scored.

If the question is a childhood exposure history, not this week’s mood, leave this scale. The childhood trauma screens list is the selection sheet for that hour. An EPDS total does not answer it.

If the job is a repeated depression, anxiety, alliance, or functioning measure outside pregnancy and postpartum, use the scales for mental health matrix. That matrix is not an EPDS. It does not contain item wording, and it does not replace the Spanish file.

These four validations are not a US norm. A client in your county may read Mexican Spanish, Caribbean Spanish, or a mix. Name the version. If your agency has adopted a different Spanish form, write that form’s name and the cut your protocol actually uses. Do not blend it with the numbers in the table.

Download the scales matrix

You already chose the Spanish file and the cut. The scales matrix is the next job: which brief outpatient measure you repeat, and when you stop. It does not replace an Edinburgh Postnatal Depression Scale Spanish form, and it will not give you item text.

References

• Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782-786.
• Garcia-Esteve, L., Ascaso, C., Ojuel, J., & Navarro, P. (2003). Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. Journal of Affective Disorders, 75(1), 71-76.
• Alvarado-Esquivel, C., Sifuentes-Alvarez, A., Salas-Martinez, C., & Martínez-García, S. (2006). Validation of the Edinburgh Postpartum Depression Scale in a population of puerperal women in Mexico. Clinical Practice and Epidemiology in Mental Health, 2, Article 33.
• Alvarado-Esquivel, C., Sifuentes-Alvarez, A., & Salas-Martinez, C. (2014). Validation of the Edinburgh Postpartum Depression Scale in a population of adult pregnant women in Mexico. Journal of Clinical Medicine Research, 6(5), 374-378.
• Vega-Dienstmaier, J. M., Mazzotti Suárez, G., & Campos Sánchez, M. (2002). Validation of a Spanish version of the Edinburgh Postnatal Depression Scale. Actas Españolas de Psiquiatría, 30(2), 106-111.
• Jadresic, E., Araya, R., & Jara, C. (1995). Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Chilean postpartum women. Journal of Psychosomatic Obstetrics and Gynaecology, 16(4), 187-191.
• Black Dog Institute. (n.d.). The Edinburgh Postnatal Depression Scale (EPDS).