Need of a Comprehensive and Feasible Psychometric Test in the Assessment of Perinatal Mental Health – A Systematic Review

Notice

This is an unedited manuscript accepted for publication and provided as an Article in Press for early access at the author’s request. The article will undergo copyediting, typesetting, and galley proof review before final publication. Please be aware that errors may be identified during production that could affect the content. All legal disclaimers of the journal apply.

Year : 2025 | Volume : 02 | 02 | Page :
    By

    Anupa Devi Kairy Kairy,

  • Sneha Bharadwaj,

  • Kajal Tomar,

  • Deepika Chamoli Shahi,

  1. Director Perinatal Mental Therapy, Speakingcube Online Mental Health Consulting Foundation, Uttarakhand, India
  2. Counselling Psychologist, Speakingcube Online Mental Health Consulting Foundation, Uttarakhand, India
  3. Counselling Psychologist and Research Assistant, Speakingcube Online Mental Health Consulting Foundation, Uttarakhand, India
  4. Director and Founder, Speakingcube Online Mental Health Consulting Foundation, Uttarakhand, India

Abstract

The perinatal period is a period of happiness as well as hardships. A woman undergoes many psychological changes during this period which makes her prone to mental health disorders that can be detrimental to the health of the women and her child. Its essential to detect these disorders as early as possible and hence a psychometric test or tool which is easy to administer and interpret is needed. Globally various tools are available for use in perinatal period. The aim of this study is to assess the need of a comprehensive and feasible psychometric test in the assessment of perinatal mental health. We looked through databases such as Springer, Elsevier, Web of Science, PubMed, and Google Scholar. Research articles on various tools used in assessment of perinatal mental health disorders were reviewed. We have gone through 105 papers and identified 50 such articles which spoke about various tools used globally for screening perinatal mental health disorders for our systematic review. We reached the conclusion that there is no set standard for which tool to be used, time and frequency of administration and validation of tools to be used in various settings.

Keywords: Perinatal mental health disorders, psychometric tools, Psychological Assessment, Early Detection, Screening Tools

How to cite this article:
Anupa Devi Kairy Kairy, Sneha Bharadwaj, Kajal Tomar, Deepika Chamoli Shahi. Need of a Comprehensive and Feasible Psychometric Test in the Assessment of Perinatal Mental Health – A Systematic Review. International Journal of Behavioral Sciences. 2025; 02(02):-.
How to cite this URL:
Anupa Devi Kairy Kairy, Sneha Bharadwaj, Kajal Tomar, Deepika Chamoli Shahi. Need of a Comprehensive and Feasible Psychometric Test in the Assessment of Perinatal Mental Health – A Systematic Review. International Journal of Behavioral Sciences. 2025; 02(02):-. Available from: https://journals.stmjournals.com/ijbsc/article=2025/view=217270


References

1. Abrahams, Z., Schneider, M., Field, S. & Honikman,S. (2019).Validation of a brief mental health screening tool for pregnant women in a low socio-economic setting. BMC Psychol 7, 77. https://doi.org/10.1186/s40359-019-0355-3
2. Adhikari, K., Patten, S. B., Williamson, T., Patel, A. B., Premji, S., Tough, S., et al. (2020). Assessment of anxiety during pregnancy: are existing multiple anxiety scales suitable and comparable in measuring anxiety during pregnancy? Journal of Psychosomatic Obstetrics & Gynecology, 42(2), 140–146. https://doi.org/10.1080/0167482X.2020.1725462
3. Bhat, A., Nanda, A., Murphy, L., Ball, A. L., Fortney, J., & Katon, J. (2022). A systematic review of screening for perinatal depression and anxiety in community-based settings. Archives of women’s mental health, 25(1), 33–49. https://doi.org/10.1007/s00737-021-01151-2
4. Chan, A. W., Reid, C., Skeffington, P., & Marriott, R. (2021). A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective. Archives of women’s mental health, 24(3), 353–365. https://doi.org/10.1007/s00737-020-01084-2
5. Chen, C., Okubo, R., Okawa, S., Nakagawa, S., & Tabuchi, T. (2023). The diagnostic accuracy of the Edinburgh Postnatal Depression Scale without the self-harm item. Journal of psychiatric research, 165, 70–76. https://doi.org/10.1016/j.jpsychires.2023.07.015
6. Cox J. (2017). Use and misuse of the Edinburgh Postnatal Depression Scale (EPDS): a ten point ‘survival analysis’. Archives of women’s mental health, 20(6), 789–790. https://doi.org/10.1007/s00737-017-0789-7
7. Cox J. (2019). Thirty years with the Edinburgh Postnatal Depression Scale: voices from the past and recommendations for the future. The British journal of psychiatry: the journal of mental science, 214(3), 127–129. https://doi.org/10.1192/bjp.2018.245
8. El-Den, S., Pham, L., Anderson, I., Yang, S., Moles, R. J., O’Reilly, C. L., Boyce, P., Raine, K. H., & Raynes-Greenow, C. (2022). Perinatal depression screening: a systematic review of recommendations from member countries of the Organisation for Economic Co-operation and Development (OECD). Archives of women’s mental health, 25(5), 871–893. https://doi.org/10.1007/s00737-022-01249-1
9. Fairbrother, N., Albert, A., Keeney, C., Tchir, D., & Cameron, R. B. (2023). Screening for Perinatal OCD: A Comparison of the DOCS and the EPDS. Assessment, 30(4), 1028–1039. https://doi.org/10.1177/10731911211063223
10. Fairbrother, N., Corbyn, B., Thordarson, D. S., Ma, A., & Surm, D. (2019). Screening for perinatal anxiety disorders: Room to grow. Journal of affective disorders, 250, 363–370. https://doi.org/10.1016/j.jad.2019.03.052
11. Fijean, A. L., Marçais, M., Banasiak, C., Morel, O., Dahlhoff, S., Olieric, M. F., Mottet, N., Epstein, J., & Bertholdt, C. (2024). Universal screening of postpartum depression with Edinburgh Postpartum Depression Scale: A prospective observational study. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 167(2), 758–764. https://doi.org/10.1002/ijgo.15722
12. Gomà, M., Gordo, L., Cozodoy, E., Iriarte, L., Prims, E., Ferrer, J., Sánchez, C., Llairó, A., & Arias-Pujol, E. (2023). Validation of the anxiety subscale of the Spanish version of the Edinburgh Postnatal Depression Scale (EPDS-A). Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1294206
13. Green, E. P., Tuli, H., Kwobah, E., Menya, D., Chesire, I., & Schmidt, C. (2018). Developing and validating a perinatal depression screening tool in Kenya blending Western criteria with local idioms: A mixed methods study. Journal of affective disorders, 228, 49–59. https://doi.org/10.1016/j.jad.2017.11.027
14. Gyimah, L., Agyepong, I. A., Owiredu, D., Awini, E., Yevoo, L. L., Ashinyo, M. E., Aye, S. G. E. V., Abbas, S., Cronin de Chavez, A., Mirzoev, T., & Danso-Appiah, A. (2024). Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa: systematic review. Frontiers in public health, 12, 1321689. https://doi.org/10.3389/fpubh.2024.1321689
15. Heller, H. M., Draisma, S., & Honig, A. (2022). Construct Validity and Responsiveness of Instruments Measuring Depression and Anxiety in Pregnancy: A Comparison of EPDS, HADS-A and CES-D. International journal of environmental research and public health, 19(13), 7563. https://doi.org/10.3390/ijerph19137563
16. Horáková, A., Kosova, E., Švancer, P., Marciánová, V., Koliba, P., & Šebela, A. (2022). Accuracy of the Edinburgh Postnatal Depression Scale in screening for major depressive disorder and other psychiatric disorders in women towards the end of their puerperium. Ceska gynekologie, 87(1), 19–26. https://doi.org/10.48095/cccg202219
17. Johnson, A., Stevenson, E., Moeller, L., & McMillian-Bohler, J. (2021). Systematic Screening for Perinatal Mood and Anxiety Disorders to Promote Onsite Mental Health Consultations: A Quality Improvement Report. Journal of midwifery & women’s health, 66(4), 534–539. https://doi.org/10.1111/jmwh.13215
18. Kotz, J., Marriott, R., & Reid, C. (2021). The EPDS and Australian Indigenous women: A systematic review of the literature. Women and birth : journal of the Australian College of Midwives, 34(2), e128–e134. https://doi.org/10.1016/j.wombi.2020.02.007
19. Koukopoulos, A., Mazza, C., De Chiara, L., Sani, G., Simonetti, A., Kotzalidis, G. D., Armani, G., Callovini, G., Bonito, M., Parmigiani, G., Ferracuti, S., Somerville, S., Roma, P., & Angeletti, G. (2021). Psychometric Properties of the Perinatal Anxiety Screening Scale Administered to Italian Women in the Perinatal Period. Frontiers in psychiatry, 12, 684579. https://doi.org/10.3389/fpsyt.2021.684579
20. Kozinszky, Z., & Dudas, R. B. (2015). Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period. Journal of affective disorders, 176, 95–105. https://doi.org/10.1016/j.jad.2015.01.044
21. Lasater, M. E., Beebe, M., Warren, N. E., Winch, P. J., Soucko, F., Keita, M., Doumbia, S., & Murray, S. M. (2022). Reliability and validity of a perinatal depression screening instrument in rural Mali. SSM. Mental health, 2, 100059. https://doi.org/10.1016/j.ssmmh.2021.100059
22. Lautarescu, A., Victor, S., Lau-Zhu, A., Counsell, S. J., Edwards, A. D., & Craig, M. C. (2022). The factor structure of the Edinburgh Postnatal Depression Scale among perinatal high-risk and community samples in London. Archives of women’s mental health, 25(1), 157–169. https://doi.org/10.1007/s00737-021-01153-0
23. Levis, B., Negeri, Z., Sun, Y., Benedetti, A., Thombs, B. D., & DEPRESsion Screening Data (DEPRESSD) EPDS Group (2020). Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ (Clinical research ed.), 371, m4022. https://doi.org/10.1136/bmj.m4022
24. Loyal, D., Sutter, A. L., & Rascle, N. (2020). Screening Beyond Postpartum Depression: Occluded Anxiety Component in the EPDS (EPDS-3A) in French Mothers. Maternal and child health journal, 24(3), 369–377. https://doi.org/10.1007/s10995-020-02885-8.
25. Marley, J. V., Kotz, J., Engelke, C., Williams, M., Stephen, D., Coutinho, S., & Trust, S. K. (2017). Validity and Acceptability of Kimberley Mum’s Mood Scale to Screen for Perinatal Anxiety and Depression in Remote Aboriginal Health Care Settings. PloS one, 12(1), e0168969. https://doi.org/10.1371/journal.pone.0168969
26. Martin, C., J., Norris, G., & Martin, C., R. (2020). Midwives’ role in screening for antenatal depression and postnatal depression. British Journal of Midwifery, 28(9). https://www.britishjournalofmidwifery.com/content/professional/midwives-role-in-screening-for-antenatal-depression-and-postnatal-depression/
ISSN (online): 2052-4307.
27. Meijer, J. L., Beijers, C., van Pampus, M. G., Verbeek, T., Stolk, R. P., Milgrom, J., Bockting, C. L., & Burger, H. (2014). Predictive accuracy of Edinburgh postnatal depression scale assessment during pregnancy for the risk of developing postpartum depressive symptoms: a prospective cohort study. BJOG : an international journal of obstetrics and gynaecology, 121(13), 1604–1610. https://doi.org/10.1111/1471-0528.12759
28. Mutiso, V. N., Musyimi, C. W., Tele, A., Alietsi, R., Andeso, P., & Ndetei, D. M. (2023). Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya. Transcultural psychiatry, 60(3), 476–483. https://doi.org/10.1177/13634615211043764
29. Pan, Y., & Xu, J. (2024). Can EPDS and EPDS-3A be used to replace GAD-7 to screen the anxiety of pregnant women during pregnancy examination?. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 164(3), 902–911. https://doi.org/10.1002/ijgo.15053
30. Park, S. H., & Kim, J. I. (2023). Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Archives of gynecology and obstetrics, 307(5), 1331–1345. https://doi.org/10.1007/s00404-022-06525-0
31. Perinatal OCD Screening & Screening Tools. https://iocdf.org/perinatal-ocd/for-clinical-providers/perinatal-ocd-screening-screening-tools/
32. Qiu, X., Wu, Y., Sun, Y., Levis, B., Tian, J., Boruff, J. T., Cuijpers, P., Ioannidis, J. P. A., Markham, S., Ziegelstein, R. C., Vigod, S. N., Benedetti, A., Thombs, B. D., & DEPRESsion Screening Data (DEPRESSD) EPDS Group (2023). Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific reports, 13(1), 4026. https://doi.org/10.1038/s41598-023-29114-w
33. Rondung, E., Massoudi, P., Nieminen, K., Wickberg, B., Peira, N., Silverstein, R., Moberg, K., Lundqvist, M., Grundberg, Å., & Hultcrantz, M. (2024). Identification of depression and anxiety during pregnancy: A systematic review and meta-analysis of test accuracy. Acta obstetricia et gynecologica Scandinavica, 103(3), 423–436. https://doi.org/10.1111/aogs.14734
34. Rubertsson, C., Börjesson, K., Berglund, A., Josefsson, A., & Sydsjö, G. (2011). The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nordic journal of psychiatry, 65(6), 414–418. https://doi.org/10.3109/08039488.2011.590606
35. Screening Protocol for Perinatal Mood and Anxiety Disorders for Primary Care Providers. https://hmhb-mt.org/wp-content/uploads/2020/01/Protocol-Document-Final-1.8.20.pdf
36. Shrestha, S. D., Pradhan, R., Tran, T. D., Gualano, R. C., & Fisher, J. R. (2016). Reliability and validity of the Edinburgh Postnatal Depression Scale (EPDS) for detecting perinatal common mental disorders (PCMDs) among women in low-and lower-middle-income countries: a systematic review. BMC pregnancy and childbirth, 16, 72. https://doi.org/10.1186/s12884-016-0859-2
37. Simpson, W., Glazer, M., Michalski, N., Steiner, M., & Frey, B. N. (2014). Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(8), 434–440. https://doi.org/10.1177/070674371405900806
38. Slavin, V., Creedy, D. K., & Gamble, J. (2020). Comparison of screening accuracy of the Patient Health Questionnaire-2 using two case-identification methods during pregnancy and postpartum. BMC pregnancy and childbirth, 20(1), 211. https://doi.org/10.1186/s12884-020-02891-2
39. Smith-Nielsen, J., Egmose, I., Wendelboe, K. I., Steinmejer, P., Lange, T., & Vaever, M. S. (2021). Can the Edinburgh Postnatal Depression Scale-3A be used to screen for anxiety?. BMC psychology, 9(1), 118. https://doi.org/10.1186/s40359-021-00623-5
40. Stefana, A., Mirabella, F., Gigantesco, A., Camoni, L., Perinatal Mental Health Nework, & Perinatal Mental Health Nework also includes: (2024). The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women. Journal of psychosomatic obstetrics and gynaecology, 45(1),2404967. https://doi.org/10.1080/0167482X.2024.2404967
41. Tanuma-Takahashi, A., Tanemoto, T., Nagata, C., Yokomizo, R., Konishi, A., Takehara, K., Ishikawa, T., Yanaihara, N., Samura, O., & Okamoto, A. (2022). Antenatal screening timeline and cutoff scores of the Edinburgh Postnatal Depression Scale for predicting postpartum depressive symptoms in healthy women: a prospective cohort study. BMC pregnancy and childbirth, 22(1), 527. https://doi.org/10.1186/s12884-022-04740-w
42. Teissedre, F., & Chabrol, H. (2004). Etude de l’EPDS (Echelle postnatale d’Edinburgh) chez 859 mères: dépistage des mères à risque de développer une dépression du post-partum [A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: detection of mothers at risk for postpartum depression]. L’Encephale, 30(4), 376–381. https://doi.org/10.1016/s0013-7006(04)95451-6
43. Usuda, K., Nishi, D., Okazaki, E., Makino, M., & Sano, Y. (2017). Optimal cut-off score of the Edinburgh Postnatal Depression Scale for major depressive episode during pregnancy in Japan. Psychiatry and clinical neurosciences, 71(12), 836–842. https://doi.org/10.1111/pcn.12562
44. van der Zee-van den Berg AI, Boere-Boonekamp MM, Groothuis-Oudshoorn CGM, Reijneveld SA (2019) The Edinburgh Postpartum Depression Scale: Stable structure but subscale of limited value to detect anxiety. PLoS ONE 14(9): e0221894. https://doi.org/10.1371/journal.pone.0221894
45. van Heyningen, T., Myer, L., Tomlinson, M., Field, S., & Honikman, S. (2019). The development of an ultra-short, maternal mental health screening tool in South Africa. Global mental health (Cambridge, England), 6, e24. https://doi.org/10.1017/gmh.2019.21
46. Venkatesh, K. K., Kaimal, A. J., Castro, V. M., & Perlis, R. H. (2017). Improving discrimination in antepartum depression screening using the Edinburgh Postnatal Depression Scale. Journal of affective disorders, 214, 1–7. https://doi.org/10.1016/j.jad.2017.01.042
47. Wang, L., Kroenke, K., Stump, T. E., & Monahan, P. O. (2021). Screening for perinatal depression with the Patient Health Questionnaire depression scale (PHQ-9): A systematic review and meta-analysis. General hospital psychiatry, 68, 74–82. https://doi.org/10.1016/j.genhosppsych.2020.12.007
48. Waqas, A., Koukab, A., Meraj, H., Dua, T., Chowdhary, N., Fatima, B., & Rahman, A. (2022). Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence. BMC psychiatry, 22(1), 54. https://doi.org/10.1186/s12888-022-03694-9
49. Zhao, Y., Kane, I., Wang, J., Shen, B., Luo, J., & Shi, S. (2015). Combined use of the postpartum depression screening scale (PDSS) and Edinburgh postnatal depression scale (EPDS) to identify antenatal depression among Chinese pregnant women with obstetric complications. Psychiatry research, 226(1), 113–119. https://doi.org/10.1016/j.psychres.2014.12.016
50. Zhong, Q. Y., Gelaye, B., Rondon, M. B., Sánchez, S. E., Simon, G. E., Henderson, D. C., Barrios, Y. V., Sánchez, P. M., & Williams, M. A. (2015). Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Archives of women’s mental health, 18(6), 783–792. https://doi.org/10.1007/s00737-014-0481-0.

Ahead of Print Subscription Review Article
Volume 02
02
Received 07/05/2025
Accepted 15/07/2025
Published 21/07/2025
Publication Time 75 Days
247

Login


My IP

PlumX Metrics