Abstract We endeavoured to analyze the factor structure of the Edinburgh Postnatal
Depression Scale (EPDS) during a screening programme in Hungary, using exploratory
(EFA) and confirmatory factor analysis (CFA), testing both previously published models
and newly developed theory-driven ones, after a critical analysis of the literature.
Between April 2011 and January 2015, a sample of 2967 pregnant women (between 12th
and 30th weeks of gestation) and 714 women 6 weeks after delivery completed the Hungarian
version of the EPDS in South-East Hungary. EFAs suggested unidimensionality in both
samples. 33 out of 42 previously published models showed good and 6 acceptable fit
with our antepartum data in CFAs, whilst 10 of them showed good and 28 acceptable
fit in our postpartum sample. Using multiple fit indices, our theory-driven anhedonia
(items 1,2) – anxiety (items 4,5) – low mood (items 8,9) model provided the best fit
in the antepartum sample. In the postpartum sample, our theory-driven models were
again among the best performing models, including an anhedonia and an anxiety factor
together with either a low mood or a suicidal risk factor (items 3,6,10). The EPDS
showed moderate within- and between-culture invariability, although this would also
need to be re-examined with a theory-driven approach.
