Edinburgh Postnatal Depression Scale

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used tool to help identify possible symptoms of depression in postpartum women. It was developed in Edinburgh, Scotland, and has been validated in numerous countries and languages. Here are key aspects of the EPDS:

  1. Purpose: The primary aim of the EPDS is to screen for postnatal depression, a type of depression that can occur in women after giving birth. It is not a diagnostic tool but rather a screening tool to identify those who may need further evaluation.
  2. Questionnaire Format: The EPDS consists of 10 questions. Each question has four possible answers that are scored on a scale from 0 to 3, depending on the severity or frequency of the symptoms.
  3. Scoring: The total score is calculated by adding together the scores from each of the 10 questions. The maximum possible score is 30. Higher scores indicate a greater likelihood of depression.
  4. Threshold for Concern: Different thresholds are used in different settings and populations, but a common cut-off is a score of 10 or higher. Scores above this threshold suggest that the woman may be experiencing significant symptoms of depression and should be evaluated further.
  5. Timeframe: The questions in the EPDS refer to how the mother has felt during the previous 7 days.
  6. Utility: The EPDS is useful because it focuses on the emotional and psychological aspects of postpartum depression, rather than physical symptoms which might be common in postpartum women (like tiredness or changes in sleeping patterns).
  7. Limitations: While the EPDS is a valuable tool for screening, it should not be used as the sole method for diagnosing postnatal depression. A comprehensive clinical evaluation is necessary for a diagnosis.
  8. Follow-Up: If a woman scores above the threshold on the EPDS, it is important for her to receive further assessment from a healthcare professional. This may include a detailed medical evaluation and possibly referral to a mental health specialist.

The EPDS is a simple, quick, and non-invasive tool that can be administered in a clinical setting or even self-administered. Its widespread use helps in the early detection and treatment of postnatal depression, which is crucial for the well-being of both the mother and the child.

 Here are the 10 questions:

  1. I have been able to laugh and see the funny side of things:
    • As much as I always could (0)
    • Not quite so much now (1)
    • Definitely not so much now (2)
    • Not at all (3)
  2. I have looked forward with enjoyment to things:
    • As much as I ever did (0)
    • Rather less than I used to (1)
    • Definitely less than I used to (2)
    • Hardly at all (3)
  3. I have blamed myself unnecessarily when things went wrong:
    • Yes, most of the time (3)
    • Yes, some of the time (2)
    • Not very often (1)
    • No, never (0)
  4. I have been anxious or worried for no good reason:
    • No, not at all (0)
    • Hardly ever (1)
    • Yes, sometimes (2)
    • Yes, very often (3)
  5. I have felt scared or panicky for no very good reason:
    • Yes, quite a lot (3)
    • Yes, sometimes (2)
    • No, not much (1)
    • No, not at all (0)
  6. Things have been getting on top of me:
    • Yes, most of the time I haven’t been able to cope at all (3)
    • Yes, sometimes I haven’t been coping as well as usual (2)
    • No, most of the time I have coped quite well (1)
    • No, I have been coping as well as ever (0)
  7. I have been so unhappy that I have had difficulty sleeping:
    • Yes, most of the time (3)
    • Yes, sometimes (2)
    • Not very often (1)
    • No, not at all (0)
  8. I have felt sad or miserable:
    • Yes, most of the time (3)
    • Yes, quite often (2)
    • Not very often (1)
    • No, not at all (0)
  9. I have been so unhappy that I have been crying:
    • Yes, most of the time (3)
    • Yes, quite often (2)
    • Only occasionally (1)
    • No, never (0)
  10. The thought of harming myself has occurred to me:
    • Yes, quite often (3)
    • Sometimes (2)
    • Hardly ever (1)
    • Never (0)

These questions are designed to reflect how the respondent has felt in the previous 7 days. A higher total score indicates more severe symptoms of depression, and women scoring above certain thresholds (often 10 or more) should be evaluated further. It’s important to note that the EPDS is a screening tool and not a diagnostic test.