Your EPDS score ranges from 0 to 30 and reflects the severity of depressive symptoms in the perinatal period. A score below 10 suggests that significant depression is unlikely at this time. A score of 10-12 indicates possible depression that warrants further clinical assessment and follow-up screening. A score of 13 or higher suggests likely depression of varying severity that should prompt a comprehensive clinical evaluation and discussion of treatment options.

Regardless of the total score, any positive response to question 10 (thoughts of self-harm) should be taken seriously and addressed immediately. This item asks about thoughts of harming oneself, and even a response of 'hardly ever' warrants a direct conversation with a healthcare provider about safety and suicidal ideation. Perinatal depression carries an elevated risk of self-harm and must be managed proactively.

The EPDS was specifically designed to avoid somatic symptoms (sleep disturbance, appetite changes, fatigue) that are common in normal pregnancy and postpartum life, making it more specific for detecting true depressive symptoms in this population than general depression screening tools.

The EPDS should be administered as part of routine perinatal care. Most clinical guidelines recommend screening at least once during pregnancy (often at the first prenatal visit or during the first trimester) and once postpartum (typically at the 6-week postpartum visit). Some guidelines recommend more frequent screening at each trimester and at 1, 2, 4, and 6 months postpartum.

It is also appropriate for use when a pregnant or postpartum patient presents with mood changes, difficulty bonding with the infant, excessive crying, withdrawal from family, or changes in self-care. The EPDS can be repeated over time to monitor symptom trajectory and treatment response. It has been validated for use as early as 2 weeks postpartum.

While the EPDS is the most widely used perinatal depression screening tool, it is a screening instrument and not a diagnostic test. A high score should prompt a clinical interview to confirm the diagnosis and assess for conditions that may mimic or co-occur with depression, such as anxiety disorders, bipolar disorder, postpartum psychosis, thyroid dysfunction, or anemia.

The EPDS was originally developed and validated in English-speaking populations. Although it has been translated into over 60 languages, the psychometric properties may vary across cultures, and cutoff scores may need adjustment for different populations. Cultural norms around emotional expression during motherhood can affect how women respond to certain items.

The EPDS focuses on depression and does not comprehensively assess anxiety, which is equally common in the perinatal period and frequently co-occurs with depression. If anxiety symptoms are prominent, a separate anxiety screening tool (such as the GAD-7) should be administered alongside the EPDS. The tool also does not screen for postpartum psychosis, a rare but dangerous condition requiring emergency intervention.