Edinburgh Postnatal Depression Scale (EPDS) Test

The Edinburgh Postnatal Depression Scale (EPDS) is a ten-item questionnaire published by Cox, Holden and Sagovsky in 1987 to detect depression in women after childbirth. Sri Lanka's Family Health Bureau uses it in routine postnatal care, so many mothers meet it on a paper clinic form first. Each item asks how you have felt over the past seven days — not just today — and you pick the phrase that fits best.

1. Each item scores 0–3. The response order deliberately alternates between items to reduce automatic answering, so the scoring direction is not the same for every question.
2. Items 1, 2, 4 are forward-scored — the top answer counts as 0 and the bottom as 3. The other seven items (3, 5, 6, 7, 8, 9, 10) are reverse-scored — the top answer counts as 3 and the bottom as 0. This tool bakes the correct score into every option, so you never have to track which is which.
3. Add the ten answers for a total between 0 and 30. Higher totals mean more frequent, more numerous symptoms.
4. Map the total to a likelihood band:
   • 0–9: Low likelihood
   • 10–12: Possible depression (borderline)
   • 13–30: Probable depressive symptoms

Two cut-points are widely used. The original Cox (1987) validation set the threshold at 12/13: a total of 13 or more flagged probable depression with roughly 86% sensitivity and 78% specificity. NICE guideline NG192 recommends a lower screening cut of ≥10 to catch milder cases early and prompt a conversation. This tool shows both so you can see where your score sits against each.

One rule overrides the arithmetic. Item 10 asks about thoughts of self-harm; if you endorse it at all, the tool shows Sri Lankan crisis helplines immediately, regardless of your total. Scoring is verified two ways in code — the band-table lookup is cross-checked against an independent cut-point derivation for every possible total 0–30, and each item's options are checked against the forward/reverse rule — so the number you see is reproducible to the point. The EPDS is a screen, not a diagnosis: some mothers who are depressed score below the threshold, so any concern is worth raising with a professional even at a low score.

• Cox, Holden & Sagovsky — Detection of postnatal depression: development of the 10-item EPDS (Br J Psychiatry, 1987)
• NICE guideline NG192 — Antenatal and postnatal mental health
• Family Health Bureau, Ministry of Health Sri Lanka — maternal & child health

The items, response wording, forward/reverse scoring, bands, cut-points, and crisis helpline numbers on this page were last cross-checked against the sources above on 2026-07-13. The EPDS may be reproduced, translated, and used without permission provided its copyright and source are respected (Cox et al., 1987). Sinhala and Tamil clinic versions are available through the Family Health Bureau.