Edinburgh Postnatal Depression Scale (EPDS)
10-item self-report scale for screening perinatal depression in pregnancy and up to 1 year postpartum. Score ≥13 = probable depression. Score ≥10 = risk of depression. Item 10 (suicidal ideation) always reviewed regardless of total score.
How to use & interpret
The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report screen for depression in the perinatal period (antenatal and postnatal), scored 0–30. A higher score indicates a greater likelihood of depression; commonly a threshold of around 10–13 prompts further assessment, though local cut-offs vary.
Item 10 asks about thoughts of self-harm — any positive response requires an immediate risk assessment regardless of the total score. The EPDS is a screening aid that should be followed by clinical assessment, not a diagnostic test.
Score interpretation
EPDS <10 — low risk of perinatal depression
→ Routine midwifery / obstetric care; psychoeducation; reassess at next appointment or if symptoms worsen; ALWAYS review item 10 response
EPDS 10–12 — at risk of depression
→ Repeat EPDS in 1–2 weeks; offer psychological support; inform GP and health visitor; assess item 10 (suicidal ideation) specifically; consider referral to perinatal mental health team
EPDS ≥13 — probable postnatal depression
→ Refer to perinatal mental health team; treat depression (CBT, antidepressants safe in breastfeeding — sertraline preferred); safeguarding assessment; assess safety for mother and baby; document and monitor; ALWAYS act on item 10 score >0
Interpretation bands for the EPDS. Apply clinical judgement and local guidance.
Frequently asked questions
What threshold indicates possible postnatal depression?
Scores around 10–13 or above commonly prompt further assessment, but the exact cut-off depends on the population and local guidance. Any positive item 10 needs immediate risk assessment whatever the total.
References
- Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–786.
Related
Curated clinical cross-links plus same-class fallbacks.
- Methotrexate (Ectopic) · Antimetabolite (Ectopic Pregnancy Management)
- Hydralazine (IV — Acute Hypertension in Pregnancy) · Vasodilator (Antihypertensive)
- Methyldopa (Chronic Hypertension in Pregnancy) · Centrally Acting Antihypertensive
- Enoxaparin (VTE in Pregnancy) · Low Molecular Weight Heparin (LMWH) — VTE Prophylaxis/Treatment
- Folic Acid (Pre-conception and Pregnancy) · Vitamin / Neural Tube Defect Prevention
- Ferric Carboxymaltose (IV Iron — Pregnancy) · IV Iron Preparation — Iron Deficiency Anaemia in Pregnancy
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.