Edinburgh Postnatal Depression Scale (EPDS)

Instructions:

As you are pregnant or have recently had a baby, we would like to know how you are feeling. Please check the answer that comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today.

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

Description

The Edinburgh Postnatal Depression Scale (EPDS) is a short 10-item self report questionnaire designed to identify mothers at risk for prenatal and and postnatal depression. Postpartum depression is the most common complication of childbearing and rates of help-seeking for postnatal depression are generally low, making screening important. The scale indicates how the mother has felt during the previous week. In doubtful cases it may be useful to repeat the tool after 2 weeks. The scale will not detect mothers with anxiety neuroses, phobias or personality disorders.

Validity and Reliability

After extensive pilot interviews, Cox, Holden and Sagovsjy (1987) carried out a validation study on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldbergs Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. Milgrom, Mendelsohn and Gemmill (2011) reviewed existing validation research for the EPDS and found that screening with the EPDS always facilitated an increase in identification rates, over the key range of prevalence values. The EPDS defined a sub-group with prevalence between 5-fold and 17-fold greater than the general population. A central estimate of PPV (at a prevalence of 6.8%) was 62%.

Interpretation

Mothers who score 13 and above are likely to be suffering from a depressive illness of varying severity. At a score of 13 there is an 80% chance that the mother has depression. Scores 13 and above represent an increased risk of developing depression of between 5 and 17 times the general population compared to new mothers. The EPDS score should not override clinical judgment. A careful clinical assessment should be carried out to confirm the diagnosis. Results consist of a total score as well as short interpretive text based on the cut off score of 13. It is important to always look at the client’s response to question 10, which pertains to suicidal thoughts.

Developer

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150:782-786

Number Of Questions

10

References

Milgrom, J., Ericksen, J., Negri, L., & Glemmil, A. (2011). Screening for postnatal depression in routine primary care: Properties of the EPDS in an Australian sample. Australian and New Zealand Journal of Psychiatry, 39, 833-839.

Developer Reference:

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150:782-786

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