Edinburgh Postnatal Depression Scale (EPDS) for Postpartum Depression

Edinburgh Postnatal Depression Scale (EPDS) Form
Baby's Name(Required)
Mother's Name(Required)
Mother's OBGYN's Last Name
MM slash DD slash YYYY
MM slash DD slash YYYY

In the past 7 days:
1. I have been able to laugh and see the funny side of things.(Required)
2. I have looked forward with enjoyment to things.(Required)
3. I have blamed myself unnecessarily when things went wrong.(Required)
4. I have been anxious or worried for no good reason.(Required)
5. I have felt scared or panicky for no very good reason.(Required)
6. Things have been getting on top of me.(Required)
7. I have been so unhappy that I have had difficulty sleeping.(Required)
8. I have felt sad or miserable.(Required)
9. I have been so unhappy that I have been crying.(Required)
10. The thought of harming myself has occurred to me.(Required)

By providing this information, I give permission for PHS to relay my EPDS information to my OBGYN as identified above.

*Source: Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Sclae. Br J Psychiatry. 1987;150:782-786.