THE EDINBURGH POSTPARTUM DEPRESSION SCALE (EPDS)

Postpartum Depression (PPD), same as Postnatal Depression (PND – which by the way, I have found is used a lot in the UK) is one of the most common mental health disorders in women. Statistics show that between 11 and 20% of women who deliver every year will experience symptoms of PPD. That’s about 2 in every 10 women are going to get PPD. One of the tools that has been developed to identify women who are at risk of perinatal (that is both antenatal and postpartum) depression is the Edinburgh Postnatal Depression Scale (EPDS). EPDS is an efficient screening tool that consists of 10 questions listed alongside a set of values. Below are the guidelines for using the EPDS.

  1. The mom-to-be/ mom is asked to tick the answer that describes closely how she has been feeling in the previous 7 days.
  2. All questions must be answered.
  3. Caution should be exercised to ensure that answers are not discussed as this could skew the results. That is, answers should only come from the expectant woman or mother herself.

NOTE: The EPDS is not a diagnostic tool and must be used alongside clinical assessment. For this reason, it should not be used for self-diagnosis. If you go through this set of questions and suspect that you may be suffering, consult a doctor to ensure you get professional help. Secondly, one of the questions (#10) is on suicidal thoughts and must be answered before the report is submitted. If the item is checked, a follow up should be made so as to ascertain the level of risk and make the necessary arrangements for mother and child.

Read More: Depression during pregnancy

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. 

Here is an example, already completed. 

I have felt happy:

 [ ] Yes, all the time 

 [X ] Yes, most of the time 

[ ] No, not very often

[ ] No, not at all

This would mean: “I have felt happy most of the time” during the past week. 

Please complete the other questions in the same way.

 

In the past 7 days:

  1. I have been able to laugh and see the funny side of things

[ ] As much as I always could

[ ] Not quite so much now

[ ] Definitely not so much now

[ ] Not at all

 

  1. I have looked forward with enjoyment to things

[ ] As much as I ever did

[ ] Rather less than I used to

[ ] Definitely less than I used to

[ ] Hardly at all

 

*3   .I have blamed myself unnecessarily when things went wrong

[ ] Yes, most of the time

[ ] Yes, some of the time

[ ] Not very often

[ ] No, never

 

  1. I have been anxious or worried for no good reason

[ ] No, not at all

[ ] Hardly ever Yes

[ ] sometimes Yes

[ ] very often

 

*5.  I have felt scared or panicky for no very good reason

[ ] Yes, quite a lot

[ ] Yes, sometimes

[ ] No, not much

[ ] No, not at all

 

*6.  Things have been getting on top of me

[ ] Yes, most of the time I haven’t been able to cope at all

[ ] Yes, sometimes I haven’t been coping as well as usual

[ ] No, most of the time I have coped quite well

[ ] No, have been coping as well as ever

 

*7.  I have been so unhappy that I have had difficulty sleeping

[ ] Yes, most of the time

[ ] Yes, sometimes

[ ] Not very often

[ ] No, not at all

 

 

*8.  I have felt sad or miserable

[ ] Yes, most of the time

[ ] Yes, quite often

[ ] Not very often

[ ] No, not at all

 

*9   I have been so unhappy that I have been crying

[ ] Yes, most of the time

[ ] Yes, quite often

[ ] Only occasionally

[ ] No, never

 

 

*10.The thought of harming myself has occurred to me

[ ] Yes, quite often

[ ] Sometimes

[ ] Hardly ever

[ ] Never

 

SCORING

QUESTIONS 1, 2, & 4 (without an *)

Are scored 0, 1, 2 or 3 with top box scored as 0 and the bottom box scored as 3

QUESTIONS 3, 5¬10 (marked with an *)

Are reverse scored, with the top box scored as a 3 and the bottom box scored as 0

Scores

0-9: Scores in this range may indicate the presence of some symptoms of distress that may be short-lived and are less likely to interfere with day to day ability to function at home or at work. However if these symptoms have persisted more than a week or two further enquiry is warranted.

10-12 : Scores within this range indicate presence of symptoms of distress that may be discomforting. Repeat the EPDS in 2 weeks time and continue monitoring progress regularly

. If the scores increase to above 12 assess further and consider referral as needed.

13 +: Scores above 12 require further assessment and appropriate management as the likelihood of depression is high. Referral to a psychiatrist/psychologist may be necessary.

Item 10: Any woman who scores 1, 2 or 3 on item 10 requires further evaluation before leaving the office to ensure her own safety and that of her baby.

 

Resource Material

Source: 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.

Screening for antenatal depression with the Edinburgh Depression Scale

 

 

 

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