How to Score the EPDS (Edinburgh Postnatal Depression Scale)
The EPDS is ten items about the past seven days, each scored 0 to 3, for a total out of 30. Seven of the ten items are reverse-scored, which is where nearly every hand-scoring error happens.
This page shows the scoring applied to a full form, sets out the bands and the 10-versus-13 cut-off decision, and explains why item 10 is treated as a separate safety screen rather than one-tenth of a total.
Step-by-step scoring
Score range: 0-30 (ten items scored 0-3; items 3, 5, 6, 7, 8, 9 and 10 are reverse-scored)
- 1Items 1, 2 and 4 are scored 0, 1, 2, 3 from top to bottom as printed.
- 2Items 3, 5, 6, 7, 8, 9 and 10 are reverse-scored: 3, 2, 1, 0 from top to bottom.
- 3Add the ten item scores for a total from 0 to 30.
- 4Record item 10 separately as a self-harm indicator, whatever the total.
A worked example
| Item | Response and score |
|---|---|
| 1. Able to laugh and see the funny side | Reverse-scored: 'not so much now' = 1 |
| 2. Looked forward with enjoyment to things | Reverse-scored: 'definitely less' = 2 |
| 3. Blamed myself unnecessarily | Reverse-scored: 'yes, some of the time' = 2 |
| 4. Anxious or worried for no good reason | Scored as printed: 'yes, sometimes' = 1 |
| 5. Scared or panicky for no good reason | Reverse-scored: 'yes, sometimes' = 2 |
| 6. Things have been getting on top of me | Reverse-scored: 'sometimes not coping' = 2 |
| 7. So unhappy I have had difficulty sleeping | Reverse-scored: 'yes, sometimes' = 1 |
| 8. Sad or miserable | Reverse-scored: 'yes, quite often' = 2 |
| 9. So unhappy I have been crying | Reverse-scored: 'only occasionally' = 1 |
| 10. Thought of harming myself | Reverse-scored: 'hardly ever' = 1 — and requires a same-visit risk conversation |
Total = 15, above the classic cut-off of 13, so this is a positive screen requiring diagnostic assessment. Independently of that total, item 10 scored 1, so a structured risk assessment and documented safety plan are required before the patient leaves.
Score ranges and what to do next
| Score | Severity | Next step |
|---|---|---|
| 0-8 | Low likelihood of depression | Screen negative. Continue routine care and rescreen at the next scheduled point; perinatal mood can change quickly. |
| 9-11 | Possible depression | Borderline. Offer support, discuss symptoms, and rescreen in 2-4 weeks. Some services treat 9 or 10 as the action threshold in high-risk populations. |
| 12-13 | Probable depression | At or above the most commonly used cut-off of 13 (and above the 12 used in many services). Arrange a diagnostic assessment and discuss treatment options. |
| 14-30 | Likely moderate-to-severe depression | Screen strongly positive. Arrange prompt assessment and treatment, review social supports and infant safety, and consider psychiatric referral at the higher end. |
Scoring mistakes to avoid
- Scoring items 3, 5, 6, 7, 8, 9 and 10 in the printed direction instead of reversing them.
- Adding item 10 into the total and then moving on. Any endorsement needs a same-visit risk conversation regardless of the total.
- Changing cut-off between visits or clinicians. Choose 10 or 13 per service, document it, and pair it with a follow-up pathway.
- Having the patient complete it in front of a partner, which reliably changes answers about self-harm and the relationship.
- Starting an antidepressant on a positive screen without asking about mania or family history of bipolar disorder.
What individual EPDS scores mean
What does an EPDS score of 10 mean?
Ten sits just below the classic cut-off of 13 and above the more sensitive threshold of 9 or 10 used in many services. It means possible depression: have a symptom conversation, offer support, and rescreen in two to four weeks rather than treating the score as negative.
What does an EPDS score of 11 mean?
Eleven is a borderline positive. It is above the 10-or-higher threshold used for possible minor depression and below the 13 cut-off for probable major depression. A diagnostic conversation is appropriate now, not at the next visit.
What is a positive EPDS score?
The original validation used 13 or higher for probable major depression. Many national guidelines use 10 or higher to trigger further assessment because it detects more cases, accepting more false positives.
What if item 10 is endorsed but the total is low?
Any endorsement of item 10 requires a same-visit risk assessment regardless of the total. A low total with a positive item 10 is a positive screen for the purpose of safety.
Is a score of 30 possible?
Yes — 30 is the maximum. Very high totals indicate severe symptoms and warrant urgent assessment, including consideration of postpartum psychosis if there is any confusion, agitation, or unusual beliefs.
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Scoring reference for clinicians and patients. Not medical advice, and no score is a diagnosis. See our medical disclaimer.