{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:37:02Z","timestamp":1789177022821,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF21OC0072397"],"award-info":[{"award-number":["NNF21OC0072397"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024075","name":"Region Syddanmark","doi-asserted-by":"publisher","award":["A5752"],"award-info":[{"award-number":["A5752"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024075","name":"Region Syddanmark","doi-asserted-by":"publisher","award":["A1784"],"award-info":[{"award-number":["A1784"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postpartum depression (PPD) can be measured in various ways, including questionnaire\u2010based symptom scores or through administrative health databases. We examined the overlap between symptom\u2010based and register\u2010based PPD definitions and assessed the consistency in exposure\u2010outcome associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We linked Danish nationwide health registers to PPD screening records (Edinburgh Postnatal Depression Scale, EPDS) at 2\u2009months postpartum from women screened between January 1, 2015, and December 31, 2021. We defined symptom\u2010based PPD as an EPDS \u2265\u200911, and register\u2010based PPD as an antidepressant prescription or hospital depression diagnosis within 1\u2009year postpartum. We estimated the overlap between women with register\u2010based and symptom\u2010based PPD, as well as between continuous EPDS scores and register\u2010based treatment indicators. We evaluated consistency between the two definitions using logistic regression analyses for socioeconomic, obstetric, demographic\u2010 and health\u2010related exposures from which we obtained odds ratios (ORs) for each PPD definition and calculated ratio of odds ratios (ROR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 157,193 mothers (132,593 unique), 11,193 (7.1%) had symptom\u2010based PPD and 2409 (1.5%) had register\u2010based PPD. Of those with symptom\u2010based PPD, 8.8% also had register\u2010based PPD, while 40.8% of those with register\u2010based PPD had symptom\u2010based PPD. We observed a higher overlap with higher EPDS scores. Consistency was highest for obstetric variables but varying for demographic\u2010 and health\u2010related exposures (ROR register\u2010based vs. symptom\u2010based 1.84 [95% CI 1.67\u20132.03] for psychiatric history and 0.75 [95% CI 0.68\u20130.83] for primiparity).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed substantial differences and limited overlap between symptom\u2010based and register\u2010based PPD. Register\u2010based measures capture hospital\u2010based diagnoses and pharmacological treatment only, but not all treatment within the healthcare system, and differences may reflect a combination of severity, symptom transience, misclassification, and timing of measurement. Consistency in exposure\u2010outcome associations varied, particularly for certain exposures. Our findings underline the importance of considering both the nature and implications of PPD definitions in epidemiological research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.70090","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T07:45:30Z","timestamp":1776152730000},"page":"50-59","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Postpartum Depression: Overlap Between Symptom\u2010Based and Register\u2010Based Measures"],"prefix":"10.1111","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4507-5295","authenticated-orcid":false,"given":"Sofie","family":"Egsgaard","sequence":"first","affiliation":[{"name":"Research Unit of Child and Adolescent Psychiatry, Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7637-3730","authenticated-orcid":false,"given":"Mette","family":"Bliddal","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health University of Southern Denmark  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Department of Gynecology and Obstetrics Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7487-3427","authenticated-orcid":false,"given":"Mette\u2010Marie Zacher","family":"Kjeldsen","sequence":"additional","affiliation":[{"name":"NCRR\u2010National Centre for Register\u2010Based Research, Department of Public Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4519-1536","authenticated-orcid":false,"given":"Xiaoqin","family":"Liu","sequence":"additional","affiliation":[{"name":"NCRR\u2010National Centre for Register\u2010Based Research, Department of Public Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0103-5534","authenticated-orcid":false,"given":"Kathrine Bang","family":"Madsen","sequence":"additional","affiliation":[{"name":"Research Unit of Child and Adolescent Psychiatry, Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"NCRR\u2010National Centre for Register\u2010Based Research, Department of Public Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3981-9438","authenticated-orcid":false,"given":"Merete Lund","family":"M\u00e6gb\u00e6k","sequence":"additional","affiliation":[{"name":"NCRR\u2010National Centre for Register\u2010Based Research, Department of Public Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-7147","authenticated-orcid":false,"given":"Trine","family":"Munk\u2010Olsen","sequence":"additional","affiliation":[{"name":"Research Unit of Child and Adolescent Psychiatry, Department of Clinical Research University of Southern Denmark  Odense 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