Replicability of structural models of the Edinburgh Postnatal Depression Scale (EPDS) in a community sample of postpartum African American women with low socioeconomic status

The Edinburgh Postnatal Depression Scale (EPDS) is increasingly used in public health and social service programs serving postpartum women of racially, ethnically, and socioeconomically diverse backgrounds at risk fordepression. However, we know little about its factor structure across groups of women with implications for measuring symptom levels in research. This study evaluated the underlying structure of the EPDS using a confirmatory factor analyses model comparison approach of five factor models from the literature in a purposive community sample of 169 postpartum African American women of low socioeconomic status. Participants were identified through an exhaustive review of local health department program files dated August 2006 to August 2010 in a Midwestern state of USA. Tuohy and McVey's(Br J Clin Psychol 47:153-169, 2008) three-factor model (depression, anxiety, and anhedonia) demonstrated the best fit to the data with a nonsignificant Satora-Bentler scaled chi-square value (21.70, df= 24, p=0.60) and the lowest root mean square error of approximation (0.00) and standardized root mean square residual (0.05) values. The results call for further study of the factor structure of the EPDS in other racial and ethnic groups and cautious use of the EPDS among perinatal women of racially, ethnically, and socioeconomically diverse backgrounds until its factorial invariance is better understood.