Further assessment of Depression
The EPDS is a screening tool and can be used to predict if a woman has a higher likelihood of depression.
Below are a summary of the scores and appropriate action that may be taken.
EPDS score = 0: may indicate that the client is not comfortable answering fully
EPDS score ≤ 9: probability of depression is low.
EPDS score 10-12: probability of depression is moderate.
EPDS score 13-14: probability of depression is relatively high. Further assessment of depression is required eg. referral to a GP or appropriate mental health professional.
EPDS score 15-24: probability of major depression is high. Further assessment of depression is required eg. referral to a GP or appropriate mental health professional.
EPDS score >25: probability of major depression is very high. Further assessment of depression is required eg. referral to a GP or appropriate mental health professional.
Actions if EPDS ≥13
- Ask further questions (see below)
- Read more on diagnostic criteria (see below)
- Refer on to health professional for further assessment of depression
- Assess for safety of mother and infant and need for crisis support if score ≥ 15
Screening requires a full diagnostic assessment to be confident that depression is present.
Diagnostic Criteria for Depression
For a diagnosis of clinical depression (DSM-5), a mother should experience at least five symptoms from the list below, of which one must be symptom 1 or symptom 2, occurring on most days in the previous two weeks.
- Depressed mood/irritability.
- Diminished interest and pleasure in activities.
- Significant weight or appetite change.
- Sleeping problems e.g. insomnia or hypersomnia.
- Feelings of worthlessness/guilt.
- Inability to think clearly or concentrate.
- Recurrent thoughts of death and/or suicide.
- Psychomotor agitation and/or retardation.
Further questions to assess for Depression
- How long have you been feeling so low? When did you start to feel like this?
- On average, what would you rate your mood out of 10 (0 being the worst and 10 being the best), When your mood is the worst, how low would you rate it? How often do you feel this low and how long does this feeling last? What would a typical day look like for you?
- What areas of your life is your low mood affecting? How has your low mood impacted on your relationships with other?/Ability to take care of your baby?/things at home/engage in activities you enjoy?