Edinburgh Postnatal Depression Scale (A review)

EDINBURGH POSTNATAL DEPRESSION SCALE
JuanitaHFNE

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.

In this sample, we will present the Edinburgh Postnatal Depression Scale questionnaire. You can read about the mentioned scale and user instructions. Below you can also find the questionnaire to check if you have postnatal depression.

EDINBURGH POSTNATAL DEPRESSION SCALE

About the Edinburgh Postnatal Depression Scale

Studies show that postpartum depression (PPD) affects at least 10 percent of women and that many depressed mothers do not get proper treatment. These mothers might cope with their baby and with household tasks, but their enjoyment of life is severely affected, and there may be long term effects on the family.

The Edinburgh Postnatal Depression Scale (EPDS) was developed to assist health professionals in detecting mothers suffering from PPD, a distressing disorder more prolonged than the “blues” (which can occur in the first week after delivery).

The scale consists of 10 short statements. A mother checks off one of four possible answers that are closest to how she has felt during the past week. Most mothers quickly complete the scale in less than five minutes.

Instructions for Users

Below are a few instructions for users of EPD scale:

  • The mother is asked to underline 1 of 4 possible responses that come the closest to how she has been feeling the previous seven days;
  • All ten items must be completed;
  • Care should be taken to avoid the possibility of the mother discussing her answers with others (answers come from the mother or pregnant woman);
  • The mother should complete the scale herself unless she has limited English or has difficulty with reading. 

The Questionnaire of the Edinburgh Postnatal Depression Scale

  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  Not so much now

3  Not at all

  1. I have looked forward with enjoyment to things.

0  As much as I ever did

1  Slightly less than I used to

2  Less than I used to

3  Hardly at all

  1. I had 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

  1. 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

  1. I have felt scared or panicky for no good reason.

3  Yes, quite a lot

2  Yes, sometimes

1  No, not much

0  No, not at all

  1. Things have been getting on top of me.

3  Yes, most of the time I have not been able to cope

2  Yes, sometimes I have not 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

  1. 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

  1. 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

  1. 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

  1. The thought of harming myself has occurred to me.

3  Yes, quite often

2  Sometimes

1  Hardly ever

0  Never

Interpretation of the Questionnaire

EPDS ScoreInterpretationAction
Less than 8Depression not likelyContinue support
9 – 11Depression possibleSupport, re-screen in 2 – 4 weeks. Consider referral to primary care provider (PCP).
12 – 13Fairly high possibility of depressionMonitor, support and offer education. Refer to PCP.
14 and higher (positive screen)Probable depressionDiagnostic assessment and treatment by PCP or specialist.
Positive score (1, 2 or 3) onquestion 10 (suicidality risk) Immediate discussion required. Refer to PCP ± mental health specialist or emergency resource for further assessment and intervention as appropriate. The urgency of referral will depend on several factors, including whether a plan accompanies the suicidal ideation, whether there has been a history of suicide attempts, whether symptoms of a psychotic disorder are present and there is concern about harm to the baby.

Recommended books and sources

  1. HFNE “Am I Healthy?”
  2. HFNE “Anaclitic Depression”
  3. Perinatal Mental Health: A Guide to the Edinburgh Postnatal Depression Scale 
  4. Perinatal Mental Health: The EPDS Manual 
  5. Perinatal Psychiatry: Use and Misuse of the Edinburgh Postnatal Depression Scale

Conclusion

The Edinburgh Postnatal Depression Scale (EPDS) was developed to assist health professionals in detecting mothers suffering from PPD. The scale consists of 10 short statements. A mother checks off one of four possible answers that are closest to how she has felt during the past week. 

If you want to check if you have postnatal depression, do not forget to pay attention to user instructions. 

Please feel free to comment on the content or ask any questions in the comments section below.

References

  1. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry. 1987; 150(6):782-786.
  2. Best Practice Guidelines for Mental Health Disorders in the Perinatal Period

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