> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.
# EPDS — perinatal depression screen
> The Edinburgh Postnatal Depression Scale — 10 items, validated for use during pregnancy and through the first year postpartum, with a self-harm flag on Item 10.
The EPDS is the most widely used perinatal depression screen in the
world. Ten items, two to three minutes to complete, designed
specifically for the perinatal window — the months around birth, when
typical depression measures can over-flag normal postpartum fatigue and
sleep disruption.
## What it measures
Perinatal mood symptoms over the past 7 days — anhedonia, anticipatory
pleasure, self-blame, anxiety, panic, coping, sleep, sadness, crying,
and self-harm thoughts.
## When to use it
* Routine perinatal screening at known risk points — typically late
pregnancy and 6-8 weeks postpartum
* Any session with a perinatal client where mood is on the agenda
* Treatment-response tracking for perinatal mood disorder
* Re-screening when something shifts (a NICU stay, a feeding crisis,
a relationship strain)
Validated for use with **fathers** (Matthey 2008) and **antenatally**
(Murray & Cox 1990) — not just for postpartum mothers.
## How clients fill it out
Three minutes self-administered. The instructions ask about the past
seven days, not just today — that's part of the canonical instrument.
## Scoring and severity cutoffs
Sum of 10 items, range 0-30.
| Total | Band |
| ----- | ------------------- |
| 0-9 | Unlikely depression |
| 10-12 | Possible depression |
| 13-30 | Probable depression |
The original Cox 1987 cutoff for probable depression is **≥13**.
**≥10** is the lower cutoff used in many perinatal programs as a
sensitivity-favouring trigger for follow-up.
Items 3, 5, 6, 7, 8, 9, and 10 are reverse-scored. Rivet handles the
inversion inside the answer options — you don't have to think about it.
**Item 10** ("The thought of harming myself has occurred to me")
carries a self-harm flag. Any response above "Never" warrants a
same-session clinical conversation — regardless of the total score.
A perinatal client with a low total and a positive Item 10 is still
a clinical event.
## How to read it
A single EPDS doesn't diagnose perinatal depression. It triggers a
clinical conversation. Two or three administrations across the
perinatal window — late pregnancy, 6-8 weeks postpartum, and at any
pediatric well-baby visit you can coordinate with — are the most
useful pattern.
The Item 10 flag is independent of the band. Don't let a "possible
depression" total override an Item 10 yes.
## Is it free to use?
**Yes.** The Royal College of Psychiatrists permits free reproduction with citation, and the required citation travels with the template.
## Citation
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of
postnatal depression. Development of the 10-item Edinburgh Postnatal
Depression Scale. *British Journal of Psychiatry,* 150, 782-786.
The Royal College of Psychiatrists permits free reproduction provided
the citation appears on every copy. Rivet carries the full citation in
the template description.
## Related articles
Adult depression measure to pair with the EPDS for non-perinatal
weeks or to triangulate severity.
Perinatal anxiety is common alongside perinatal depression —
GAD-7 captures it directly.
How Item 10 surfaces in the conversation and what to do with the signal.