Name: Edinburgh Postpartum Depression Scale (EPDS)

Source: Cox, JL, et al. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-786. Click here for the EPDS.

Description: The EPDS was developed for screening postpartum women for depression in outpatient, home visiting settings, or at the 6-8 week postpartum examination. It is a 10-item self-report rating scale that is also sensitive to change in severity of depression over time. While it is used predominantly in the postnatal setting, the EPDS can also be used to screen for depression during pregnancy, terminal illness, in fathers, to assess dysphoria in adoptive parents, and has been validated for use in non-postnatal women, as well as mothers and fathers of toddlers. The EPDS has been used cross-culturally, and has been translated into 23 languages, although all translations have not been validated. It also deliberately does not contain self-report items related to somatic symptoms.

Scores: Major depressive disorder (cutoff: 8.5-15.0); minor depression (cutoff: 8.0-9.0). A positive score on item 10 indicates that immediate intervention is required.

Accuracy: According to a review of validated screening instruments by Boyd et al, the EPDS had the following sensitivity (testing positive), specificity (testing negative), and positive predictive values (actual disease based on 13% prevalence rates):

Sensitivity: 59%-100%

Specificity: 49%-100%

Positive predictive value 19%-92%

Time frame: It takes approximately 5 minutes to complete the EPDS.

Cost of the tool: Free.

Relevant Literature About the EPDS:

Berle J, Aarre T, Mykletun A, et al. Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. J Affect Disord. 2003;76(1-3):151-156.

Boyd RC, Le HN, Somberg R. Review of screening instruments for postpartum depression. Arch Womens Ment Health. 2005;8:141-153.

Chaudron LH, Szilagyi PG, Kitzman HJ, et al. Detection of Postpartum Depressive Symptoms by Screening at Well-Child Visits. Pediatrics. 2004;113(3):551-558.

Cox J, Chapman G, Murray D, et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J Affect Disord. 1996;39(3):185-189.

Cox J, Holden J. Perinatal Mental Health: A guide to the Edinburgh Postnatal Depression Scale. The Royal College of Psychiatrists; 2003.

Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, et al. Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand. 2001;104(4):243-249.

Garcia-Esteve L, Ascaso C, Ojuel J, et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. J Affect Disord. 2003;75(1):71-76.

Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, et al. Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. Summary, Evidence Report/Technology Assessment No. 119. (Prepared by the RTI-University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016.) AHRQ Publication No. 05-E006-1. Rockville, MD: Agency for Healthcare Research and Quality. February 2005. [US Department of Health and Human Services]

Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). J Reprod Infant Psychol. 1990;8(2):99-107.

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