Home Assessment of the validity and reliability of edinburgh postpartum depression scale in Turkish men
Article
Licensed
Unlicensed Requires Authentication

Assessment of the validity and reliability of edinburgh postpartum depression scale in Turkish men

  • Çiğdem Alkan ORCID logo , Altuğ Didikoğlu ORCID logo EMAIL logo , Oğulcan Çöme ORCID logo , Betül Yılmaz ORCID logo and Vildan Mevsim ORCID logo
Published/Copyright: October 10, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 9

Abstract

Objectives

Perinatal depression (PD) affects individuals during pregnancy and early parenthood, resembling major depression. Recent research highlights paternal perinatal depression (PPD) in fathers. PPD has adverse effects on fathers and their children. This study assesses the Turkish version of the Edinburgh Postnatal Depression Scale (EPDS) for Turkish fathers, aiming to provide a tool for PPD identification.

Methods

This methodological study validates the EPDS for Turkish fathers and explores associations with demographic and psychosocial factors. The study involved 295 fathers with infants aged 2 weeks to 12 months. The EPDS, originally designed for perinatal depression and validated in Turkish women, was used. Fathers completed a participant information questionnaire, the EPDS, and the Beck Depression Inventory (BDI) during clinic visits. Data on sociodemographic factors, paternal roles, and pregnancy and postpartum support were collected. Mothers also completed the EPDS. Descriptive statistics, exploratory factor analysis, confirmatory factor analysis, and correlation tests were used.

Results

The study included fathers with an average age of 30.5 years, mostly with a high school education or higher. The EPDS had a mean total score of 3.1. Factor analysis suggested a three-factor structure for the EPDS in Turkish fathers, including anhedonia, anxiety, and depression. Confirmatory factor analysis validated the three-factor structure, with acceptable model fit indices. Positive correlations were found between fathers’ EPDS scores, maternal EPDS scores, and paternal BDI scores. The EPDS effectively discriminated between different levels of depression severity. Various factors, such as education level and lack of support during pregnancy and after childbirth, were associated with higher EPDS scores.

Conclusions

These findings emphasize the significance of assessing and addressing PPD in fathers, supporting the use of the EPDS as a valid tool in the Turkish context. The three-factor structure aligns with international research, highlighting the importance of a multi-dimensional approach to PPD assessment. Early intervention can mitigate PPD’s impact on fathers, mothers, and children, benefiting mental health and well-being.

Keywords: perinatal depression; edinburgh postnatal depression scale (EPDS); male; fathers; validity and reliability; psychological factors
Corresponding author: Altuğ Didikoğlu, PhD, Department of Neuroscience, Izmir Institute of Technology, Izmir, Türkiye; and Division of Neuroscience, University of Manchester, Manchester, UK, E-mail:

Acknowledgments

We would like to express our appreciation to the participants who generously volunteered their time and cooperation for this study.

  1. Research ethics: The ethical approval was granted with the decision number 2154-GOA protocol dated 03.08.2015 from the Ethics Committee of the Non-Invasive Investigations of the Medical Faculty of Dokuz Eylul University, Izmir (Turkey). In addition, Dokuz Eylul University Faculty of Medicine Department of Pediatrics checked and approved the research protocol. The study was conducted in accordance with the Declaration of Helsinki.

  2. Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.

  3. Author contributions: O.C: Project administration, Methodology, Data curation, Formal Analysis, Writing – original draft, Writing – review & editing; C.A.: Conceptualization, Data curation, Investigation, Project administration, Writing – original draft, Writing – review & editing; A.D.: Conceptualization, Methodology, Data curation, Formal Analysis, Writing – review & editing; B.Y.: Formal Analysis, Writing – review & editing; V.M.: Conceptualization, Supervision, Methodology, Writing – review & editing. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: The raw data can be obtained on request from the corresponding author.

References

1. Schumacher, M, Zubaran, C, White, G. Bringing birth-related paternal depression to the fore. Women Birth 2008;21:65–70. https://doi.org/10.1016/J.WOMBI.2008.03.008.Search in Google Scholar PubMed

2. Escribà-Agüir, V, Artazcoz, L. Gender differences in postpartum depression: a longitudinal cohort study. J Epidemiol Community Health 2011;65:320. https://doi.org/10.1136/JECH.2008.085894.Search in Google Scholar

3. Roy, R, Chakraborty, M, Bhattacharya, K, Roychoudhury, T, Mukherjee, S. Impact of perinatal maternal depression on child development. Indian J Psychiatr 2022;64:284. https://doi.org/10.4103/INDIANJPSYCHIATRY.INDIANJPSYCHIATRY_1318_20.Search in Google Scholar

4. Srinivasan, R, Pearson, RM, Johnson, S, Lewis, G, Lewis, G. Maternal perinatal depressive symptoms and offspring psychotic experiences at 18 years of age: a longitudinal study. Lancet Psychiatr 2020;7:431. https://doi.org/10.1016/S2215-0366(20)30132-2.Search in Google Scholar PubMed PubMed Central

5. Ali, NS, Mahmud, S, Khan, A, Ali, BS. Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study. BMC Psychiatr 2013;13. https://doi.org/10.1186/1471-244X-13-274.Search in Google Scholar PubMed PubMed Central

6. Faleschini, S, Rifas-Shiman, SL, Tiemeier, H, Oken, E, Hivert, MF. Associations of prenatal and postnatal maternal depressive symptoms with offspring cognition and behavior in mid-childhood: a prospective cohort study. Int J Environ Res Publ Health 2019;16. https://doi.org/10.3390/IJERPH16061007.Search in Google Scholar PubMed PubMed Central

7. Grace, SL, Evindar, A, Stewart, DE. The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Womens Ment Health 2003;6:263–74. https://doi.org/10.1007/S00737-003-0024-6.Search in Google Scholar

8. Kim, P, Swain, JE. Sad dads: paternal postpartum depression. Psychiatry 2007;4:35.Search in Google Scholar

9. Cameron, EE, Sedov, ID, Tomfohr-Madsen, LM. Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis. J Affect Disord 2016;206:189–203. https://doi.org/10.1016/J.JAD.2016.07.044.Search in Google Scholar

10. Demirci, Ö, İnan, E. Postpartum paternal depression: its impact on family and child development doğum sonrası babalık depresyonu: aile ve çocuk gelişimine etkisi. Psikiyatride güncel yaklaşımlar-current approaches in. Psychiatry 2023;15:498–507. https://doi.org/10.18863/pgy.1153712.Search in Google Scholar

11. Cui, C, Li, M, Yang, Y, Liu, C, Cao, P, Wang, L. The effects of paternal perinatal depression on socioemotional and behavioral development of children: a meta-analysis of prospective studies. Psychiatr Res 2020;284. https://doi.org/10.1016/J.PSYCHRES.2020.112775.Search in Google Scholar PubMed

12. Ashraf, S, Shah, K, Vadukapuram, R, Shah, B, Jaiswal, S, Mansuri, Z, et al.. Impact of paternal depression on child neurodevelopmental outcomes and disorders. Prim Care Companion CNS Disord 2023;25. https://doi.org/10.4088/PCC.22R03303.Search in Google Scholar

13. Chen, LC, Chen, MH, Hsu, JW, Huang, KL, Bai, YM, Chen, TJ, et al.. Association of parental depression with offspring attention deficit hyperactivity disorder and autism spectrum disorder: a nationwide birth cohort study. J Affect Disord 2020;277:109–14. https://doi.org/10.1016/J.JAD.2020.07.059.Search in Google Scholar PubMed

14. Chhabra, J, Li, W, McDermott, B. Predictive factors for depression and anxiety in men during the perinatal period: a mixed methods study. Am J Men’s Health 2022;16. https://doi.org/10.1177/15579883221079489.Search in Google Scholar PubMed PubMed Central

15. Bruno, A, Celebre, L, Mento, C, Rizzo, A, Silvestri, MC, De Stefano, R, et al.. When fathers begin to falter: a comprehensive review on paternal perinatal depression. Int J Environ Res Publ Health 2020;17. https://doi.org/10.3390/IJERPH17041139.Search in Google Scholar

16. Somerville, S, Dedman, K, Hagan, R, Oxnam, E, Wettinger, M, Byrne, S, et al.. The perinatal anxiety screening scale: development and preliminary validation. Arch Womens Ment Health 2014;17:443–54. https://doi.org/10.1007/S00737-014-0425-8/FIGURES/2.Search in Google Scholar

17. Cox, JL, Holden, JM, Sagovsky, R. Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatr 1987;150:782–6. https://doi.org/10.1192/BJP.150.6.782.Search in Google Scholar

18. Li, L, Liu, F, Zhang, H, Wang, L, Chen, X. Chinese version of the postpartum depression screening scale: translation and validation. Nurs Res 2011;60:231–9. https://doi.org/10.1097/NNR.0B013E3182227A72.Search in Google Scholar PubMed

19. Berg, RC, Solberg, BL, Glavin, K, Olsvold, N. Instruments to identify symptoms of paternal depression during pregnancy and the first postpartum year: a systematic scoping review. Am J Men’s Health 2022;16. https://doi.org/10.1177/15579883221114984.Search in Google Scholar PubMed PubMed Central

20. Tran, TD, Biggs, BA, Tran, T, Simpson, JA, De Mello, MC, Hanieh, S, et al.. Perinatal common mental disorders among women and the social and emotional development of their infants in rural Vietnam. J Affect Disord 2014;160:104–12. https://doi.org/10.1016/J.JAD.2013.12.034.Search in Google Scholar PubMed

21. Matthey, S, Barnett, B, Kavanagh, DJ, Howie, P. Validation of the edinburgh postnatal depression scale for men, and comparison of item endorsement with their partners. J Affect Disord 2001;64:175–84. https://doi.org/10.1016/S0165-0327(00)00236-6.Search in Google Scholar PubMed

22. Lai, BPY, Tang, AKL, Lee, DTS, Yip, ASK, Chung, TKH. Detecting postnatal depression in Chinese men: a comparison of three instruments. Psychiatr Res 2010;180:80–5. https://doi.org/10.1016/J.PSYCHRES.2009.07.015.Search in Google Scholar

23. Massoudi, P, Hwang, CP, Wickberg, B. How well does the edinburgh postnatal depression scale identify depression and anxiety in fathers? A validation study in a population based Swedish sample. J Affect Disord 2013;149:67–74. https://doi.org/10.1016/J.JAD.2013.01.005.Search in Google Scholar

24. Shaheen, NA, AlAtiq, Y, Thomas, A, Alanazi, HA, AlZahrani, ZE, Younis, SAR, et al.. Paternal postnatal depression among fathers of newborn in Saudi arabia. Am J Men’s Health 2019;13. https://doi.org/10.1177/1557988319831219.Search in Google Scholar PubMed PubMed Central

25. Coates, R, Ayers, S, de Visser, R. Factor structure of the edinburgh postnatal depression scale in a population-based sample. Psychol Assess 2017;29:1016–27. https://doi.org/10.1037/PAS0000397.Search in Google Scholar PubMed

26. Matsumura, K, Hamazaki, K, Tsuchida, A, Kasamatsu, H, Inadera, H, Kamijima, M, et al.. Factor structure of the edinburgh postnatal depression scale in the Japan environment and children’s study. Sci Rep 2020;10:11647. https://doi.org/10.1038/S41598-020-67321-X.Search in Google Scholar

27. Engindeniz, N. Edinburgh doğum sonrası depresyon ölçeği Türkçe formu geçerlilik ve güvenilirlik çalışması. İzmir: Ege Üniversitesi; 1996.Search in Google Scholar

28. Albicker, J, Hölzel, LP, Bengel, J, Domschke, K, Kriston, L, Schiele, MA, et al.. Prevalence, symptomatology, risk factors and healthcare services utilization regarding paternal depression in Germany: study protocol of a controlled cross-sectional epidemiological study. BMC Psychiatr 2019;19. https://doi.org/10.1186/S12888-019-2280-7.Search in Google Scholar PubMed PubMed Central

29. Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatr 1961;4:561–71. https://doi.org/10.1001/ARCHPSYC.1961.01710120031004.Search in Google Scholar

30. Hisli, N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi 1989;7:3–13.Search in Google Scholar

31. Schermelleh-Engel, K, Moosbrugger, H, Müller, H. Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res 2003;8:23–74. https://doi.org/10.23668/psycharchives.12784.Search in Google Scholar

32. Clark, LA, Watson, D. Constructing validity: basic issues in objective scale development. Psychol Assess 1995;7:309–19. https://doi.org/10.1037/1040-3590.7.3.309.Search in Google Scholar

33. Field, A. Discovering statistics using SPSS, 2nd ed. London: Sage Publications, Inc; 2005.Search in Google Scholar

34. Tuohy, A, McVey, C. Subscales measuring symptoms of non-specific depression, anhedonia, and anxiety in the edinburgh postnatal depression scale. Br J Clin Psychol 2008;47:153–69. https://doi.org/10.1111/J.2044-8260.2008.TB00463.X.Search in Google Scholar PubMed

35. King, PAL. Replicability of structural models of the edinburgh postnatal depression scale (EPDS) in a community sample of postpartum African American women with low socioeconomic status. Arch Womens Ment Health 2012;15:77–86. https://doi.org/10.1007/S00737-012-0260-8.Search in Google Scholar PubMed

36. Kubota, C, Okada, T, Aleksic, B, Nakamura, Y, Kunimoto, S, Morikawa, M, et al.. Factor structure of the Japanese version of the Edinburgh Postnatal Depression Scale in the postpartum period. PLoS One 2014;9. https://doi.org/10.1371/JOURNAL.PONE.0103941.Search in Google Scholar PubMed PubMed Central

37. Ertekin Pinar, S, Ozbek, H. Paternal depression and attachment levels of first-time fathers in Turkey. Psychiatr Care 2022;58:1082–8. https://doi.org/10.1111/PPC.12905.Search in Google Scholar

38. Boybay Koyuncu, S. Effect of the marital adjustment on the prevalence of postpartum depression in fathers. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi; 2023, 8:237–42 pp.Search in Google Scholar

39. Matsumura, K, Hamazaki, K, Tsuchida, A, Kasamatsu, H, Inadera, H, Kamijima, M, et al.. Education level and risk of postpartum depression: results from the Japan environment and children’s study (JECS). BMC Psychiatr 2019;19. https://doi.org/10.1186/S12888-019-2401-3.Search in Google Scholar

40. Rao, WW, Zhu, XM, Zong, QQ, Zhang, Q, Hall, BJ, Ungvari, GS, et al.. Prevalence of prenatal and postpartum depression in fathers: a comprehensive meta-analysis of observational surveys. J Affect Disord 2020;263:491–9. https://doi.org/10.1016/J.JAD.2019.10.030.Search in Google Scholar

41. Shariat, M, Abedinia, N, Charousaei, H, Fatahi, F. The relationship between paternal postpartum depression and psychosocial variables: a longitudinal study in Iran. J Fam Reprod Health 2022;16. https://doi.org/10.18502/JFRH.V16I4.11358.Search in Google Scholar

42. Cockshaw, WD, Thorpe, KJ, Giannotti, M, Hazell-Raine, K. Factor structure of the Edinburgh Postnatal Depression Scale in a large population-based sample of fathers. J Affect Disord 2023;340:167–73. https://doi.org/10.1016/J.JAD.2023.08.025.Search in Google Scholar PubMed

43. Hada, A, Kubota, C, Imura, M, Takauma, F, Tada, K, Kitamura, T. The Edinburgh Postnatal depression scale: model comparison of factor structure and its psychosocial correlates among mothers at one month after childbirth in Japan. Open Fam Stud J 2019;11:1–17. https://doi.org/10.2174/1874922401911010001.Search in Google Scholar

44. Edmondson, OJH, Psychogiou, L, Vlachos, H, Netsi, E, Ramchandani, PG. Depression in fathers in the postnatal period: assessment of the Edinburgh Postnatal Depression Scale as a screening measure. J Affect Disord 2010;125:365. https://doi.org/10.1016/J.JAD.2010.01.069.Search in Google Scholar

45. Engin, C, Pals, H. Patriarchal attitudes in Turkey 1990–2011: the influence of religion and political conservatism. Soc Polit Int Stud Gend State Soc 2018;25:383–409. https://doi.org/10.1093/SP/JXX021.Search in Google Scholar

46. Edvardsson, K, Ivarsson, A, Eurenius, E, Garvare, R, Nyström, ME, Small, R, et al.. Giving offspring a healthy start: parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Publ Health 2011;11:1–13. https://doi.org/10.1186/1471-2458-11-936/TABLES/4.Search in Google Scholar

Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpm-2024-0026).

Received: 2024-01-18
Accepted: 2024-09-12
Published Online: 2024-10-10
Published in Print: 2024-11-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. The utilization of artificial intelligence in enhancing 3D/4D ultrasound analysis of fetal facial profiles
  4. Commentary
  5. Respect for history: an important dimension of contemporary obstetrics and gynecology
  6. Opinion Papers
  7. Fetoscopic laser photocoagulation: a medically reasonable treatment option in the management of types II and III vasa previa
  8. Efficacy and safety of 2-drug regime dolutegravir/lamivudine in pregnancy and breastfeeding – clinical implications and perspectives
  9. Original Articles – Obstetrics
  10. The potential impact of universal screening for vasa previa in the prevention of stillbirths
  11. Preinduction cervical ripening in an outpatient setting: a prospective pilot study of a synthetic osmotic dilator compared with a double-balloon catheter
  12. Transperineal sonographic assessment of the angle of progression before the onset of labour: how well does it predict the mode of delivery in late-term pregnancy
  13. Prediction of intrapartum caesarean section in vaginal breech birth: development of models for nulliparous and multiparous women
  14. Complementary and Alternative Medicine use among pregnant women attending antenatal clinic: a point to ponder
  15. Molecular evidence that GBS early neonatal sepsis results from ascending infection: comparative hybrid genomics analyses show that microorganisms in the vaginal ecosystem, amniotic fluid, chorioamniotic membranes, and neonatal blood are the same
  16. Original Articles – Fetus
  17. Echocardiographic markers at diagnosis of persistent pulmonary hypertension of the newborn
  18. New measurement indicator of ultrasound assessment of the fetal pancreas based on anatomical landmarks and its application to fetuses with gestational diabetes mellitus
  19. Original Articles – Neonates
  20. Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of age
  21. Assessment of the validity and reliability of edinburgh postpartum depression scale in Turkish men
  22. Letter to the Editor
  23. Frequency and persistence of wide pulse pressure in the newborn population
https://doi.org/10.1515/jpm-2024-0026
Keywords for this article
perinatal depression; edinburgh postnatal depression scale (EPDS); male; fathers; validity and reliability; psychological factors

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. The utilization of artificial intelligence in enhancing 3D/4D ultrasound analysis of fetal facial profiles
  4. Commentary
  5. Respect for history: an important dimension of contemporary obstetrics and gynecology
  6. Opinion Papers
  7. Fetoscopic laser photocoagulation: a medically reasonable treatment option in the management of types II and III vasa previa
  8. Efficacy and safety of 2-drug regime dolutegravir/lamivudine in pregnancy and breastfeeding – clinical implications and perspectives
  9. Original Articles – Obstetrics
  10. The potential impact of universal screening for vasa previa in the prevention of stillbirths
  11. Preinduction cervical ripening in an outpatient setting: a prospective pilot study of a synthetic osmotic dilator compared with a double-balloon catheter
  12. Transperineal sonographic assessment of the angle of progression before the onset of labour: how well does it predict the mode of delivery in late-term pregnancy
  13. Prediction of intrapartum caesarean section in vaginal breech birth: development of models for nulliparous and multiparous women
  14. Complementary and Alternative Medicine use among pregnant women attending antenatal clinic: a point to ponder
  15. Molecular evidence that GBS early neonatal sepsis results from ascending infection: comparative hybrid genomics analyses show that microorganisms in the vaginal ecosystem, amniotic fluid, chorioamniotic membranes, and neonatal blood are the same
  16. Original Articles – Fetus
  17. Echocardiographic markers at diagnosis of persistent pulmonary hypertension of the newborn
  18. New measurement indicator of ultrasound assessment of the fetal pancreas based on anatomical landmarks and its application to fetuses with gestational diabetes mellitus
  19. Original Articles – Neonates
  20. Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of age
  21. Assessment of the validity and reliability of edinburgh postpartum depression scale in Turkish men
  22. Letter to the Editor
  23. Frequency and persistence of wide pulse pressure in the newborn population
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 26.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpm-2024-0026/html
Scroll to top button