Obstetrics & Gynaecology Psychiatry Strong — NICE CG192 / Cox 1987

Edinburgh Postnatal Depression Scale (EPDS)

10-item validated screening tool for postnatal depression. Validated for antenatal use. Score ≥13 suggests probable depression.

Used in: Depression & Anxiety

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

I have looked forward with enjoyment to things*

I have blamed myself unnecessarily when things went wrong*

I have been anxious or worried for no good reason*

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

Things have been getting on top of me*

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

I have felt sad or miserable*

I have been so unhappy that I have been crying*

The thought of harming myself has occurred to me*

Score interpretation

Low Risk 0–9

EPDS 0–9: Low risk of postnatal depression. However, if Q10 (self-harm) scored >0, manage regardless of total score.

→ Routine postnatal support. Reassess at 6–8 week check. Provide information on perinatal mental health services.

Possible Minor Depression 10–12

EPDS 10–12: Possible minor depression. Repeat screen in 2 weeks.

→ Discuss with patient. Watchful waiting or psychological support (guided self-help, CBT). Midwife / HV close follow-up. Lifestyle advice: sleep, social support.

Probable Depression — Action Required 13–30

EPDS ≥13: Probable postnatal depression. Immediate assessment required.

→ GP urgent review. Consider antidepressant (sertraline first-line, compatible with breastfeeding). Refer to perinatal mental health team. Safeguarding assessment. If Q10 (self-harm) ≥1: IMMEDIATE risk assessment and psychiatric review. Crisis team if active suicidal ideation.

Interpretation bands for the EPDS. Apply clinical judgement and local guidance.

References

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987.
NICE CG192. Antenatal and postnatal mental health: clinical management and service guidance. 2020.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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