History of EPDS and Terminology

The Edinburgh Postnatal Depression Scale (EPDS) was developed in England at health centers in Livingston and Edinburgh. It was developed to assist primary care health professionals to detect whether mothers are suffering from postnatal depression. For purposes of clarity, the terms postpartum and postnatal are used interchangeably; prenatal refers to pregnancy or pre-delivery; and perinatal refers to pregnancy and to post-delivery.

Prevalence

Postnatal depression is a distressing disorder more prolonged than the "baby blues" (which occurs in the first week after delivery), but less severe than postpartum psychosis. Studies have shown that postpartum depression affects at least 10% - 20% of women and that many depressed mothers remain untreated. While untreated mothers may cope with their baby and with household tasks, their ability to feel pleasure and enjoy life is seriously diminished. And, it is possible that if unrecognized and untreated, perinatal depression may result in long-term adverse effects on the mother, baby and the family.

Validity and Application

The EPDS, which has been widely tested, has been utilized in 23 countries and carries a significant level of sensitivity (86%) and specificity (78%) in identifying those at risk of or potentially suffering from either prenatal or postpartum depression. The EPDS is a ten-item scale, typically self-administered, requiring about five minutes to complete. In doubtful cases, it can be re-administered after two weeks. The English version is available for download from this Web site; it is also available in many languages, and has cross-cultural validity.

Some mothers may need assistance to interpret or understand the scale's colloquialisms, which are of European origin. It is helpful to remind the mother to select which of each statement's four responses comes closest to describing how she has been feeling in the past seven days.

Interpretation and Scoring

The EPDS has a maximum score of 30; a score of 10 or more may indicate possible depression of varying severity. Always pay attention to item 10, which speaks to suicidal thoughts. The EPDS score should not override clinical judgment. A careful clinical assessment should be conducted to confirm a potential diagnosis of depression. The scale will not detect anxiety disorders, phobias or personality disorders.

Reimbursement

For information about billing see the Provider Notice and refer to the "Billing Procedures" section.

The Edinburgh Postnatal Depression Scale is available in many languages. For a copy in another language call the UIC Perinatal Consultation Line at 1-800-573-6121.

Sources: British Journal of Psychiatry, June, 1987, vol. 150. By J.L. Cox, J.M. Holden, R. Sagovsky.

Perinatal Depression: Current Concepts, November, 2004. By N. Scott (satellite presentation slide show).