Detecting Anxiety in Pregnancy: Validation of the Anxiety Subscale of the Edinburgh Postnatal Depression Scale (EDS-3A) in Spanish Women

Abstract

Anxiety is one of the most common mental health disorders during pregnancy, therefore, screening instruments are needed. The Edinburgh Postnatal Depression Scale (EPDS) is one of the most widely used self-report measures. However, it has an anxiety subscale (EDS-3A) which has so far been validated in only a few countries. The aim of this study is to validate the EDS-3A as a screening instrument to detect anxiety during pregnancy in Spanish women. A cross-sectional study was carried out with a total sample of 317 pregnant women. Anxiety was assessed using the EDS-3A and the DSM-5 Structured Clinical Interview (SCID-5). The area under the ROC curve (AUC), sensitivity, specificity, the positive predictive value (PPV) and the negative predictive value (NPV) were evaluated. The optimal cut-off point of the EDS-3A, according to the SCID-5, to detect generalized anxiety during pregnancy, was 7 or higher (AUC 0.82, sensitivity of 61.5%, specificity of 86.3%, PPV of 38.7% and NPV 94.1%). The prevalence of anxious symptoms found with the EDS-3A was 19.6%. The prevalence of GAD was 12.3%. The EDS-3A is an adequate instrument for screening anxiety in Spanish pregnant women. It can be considered a useful tool in clinical practice in the field of perinatal mental health given its characteristics of free availability, easy administration and brevity.