Edinburgh Postnatal Depression Score Calculator

The EPDS measures the emotional and cognitive dimension of perinatal mood disturbance while deliberately omitting somatic items. Fatigue, broken sleep, appetite shifts and reduced libido are near-universal in the weeks after delivery, so general instruments that count them inflate scores in healthy mothers. The ten EPDS items instead ask about anhedonia, self-blame, anxiety, panic, feeling overwhelmed, sadness, crying and thoughts of self-harm, each rated 0 to 3 for the previous seven days, giving a 0 to 30 range. Items 1 and 2 are phrased positively and are reverse-scored, which is the single most common source of hand-scoring error. Within the ten items, questions 3, 4 and 5 form a widely used anxiety subscale often reported as EPDS-3A. The conventional threshold of 13 or more identifies probable major depression, with reported sensitivity around 80 to 86 percent and specificity around 78 to 87 percent depending on the population and the diagnostic reference used. A lower cut-off of 10 is often chosen for community screening where missing cases matters more than false positives, and antenatal use sometimes applies 11 or 12. Question 10 stands outside the arithmetic entirely: any answer other than Never triggers a safety assessment regardless of total. The main caveats are that a score is not a diagnosis, that translated versions do not all share the same optimal cut-off, and that social desirability, fear of child protection involvement and cultural norms about expressing distress all push scores downward.

John Cox, Jeni Holden and Ruth Sagovsky developed the scale at health centres in Livingston and Edinburgh, Scotland, and published it in the British Journal of Psychiatry in June 1987 under the title Detection of Postnatal Depression. Cox had earlier worked in Uganda on childbirth-related mental illness, which shaped his conviction that postnatal depression was widely under-recognised in routine care. The team started from existing self-report measures, including items drawn from the Irritability, Depression and Anxiety Scale and the Anxiety and Depression Scale, tested candidate questions on postnatal women, and discarded those confounded by ordinary physical recovery from birth. The surviving ten items were validated against Research Diagnostic Criteria interviews in a sample of 84 women. Adoption was rapid because the scale was short, free of somatic confounds and easy for health visitors to administer. In the United Kingdom health visitors made it a routine part of the postnatal contact through the 1990s, and NICE clinical guideline CG192 on antenatal and postnatal mental health later addressed its place in structured enquiry. The American College of Obstetricians and Gynecologists endorsed perinatal depression screening in Committee Opinion 757 in 2018, and the US Preventive Services Task Force recommendation on preventive interventions for perinatal depression reinforced the practice. Later work extended validation to pregnancy, to fathers and partners using a lower cut-off near 10, and to more than sixty language versions.