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Edinburgh Postnatal Depression Scale 1 (EPDS)

Name: Address: _

Your Date of Birth: _

Baby's Name Baby's Date of Birth: Phone: _

As you are pregnant or have recently had a baby, we would like to know how you are feeling. Please check the answerthat comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today.

Here is an example, already completed.

I have felt happy:o Yes, aU the timeIE) Yes, most of the time this would mean: "I have felt happy most of the time" during the past week.o No, not very often Please complete the other questions in the same way.o No, not at all

In the past 7 days:

1. I have been able to laugh and see the funny side of thingso As much as I always couldo Not quite so much nowo Definitely not so much nowo Not at all

*6. Things have been getting on top of meo Yes, most of the time I haven't been able

to cope at allo Yes, sometimes I haven't been coping as

as usualo No, most of the time I have copied quite wello No, I have been coping as well as ever2. I have looked forward with enjoyment to things

o As much as I ever dido Rather less than I used too Definitely less than I used too Hardly at all

*7 I have been so unhappy that I have had difficulty Sleepingo Yes, most of the timeo Yes, sometimeso Not very ofteno No, not at all*3. I have blamed myself unnecessarily when things

went wrongo Yes, most of the time[] Yes, some of the timeo Not very ofteno No, never

*8 I have felt sad or miserableo Yes, most of the timeo Yes, quite ofteno Not very ofteno No, not at all

4. I have been anxious or worried for no good reasono No, not at allo Hardly evero Yes, sometimeso Yes, very often

*9 I have been so unhappy that I have been cryingo Yes, most of the timeo Yes, quite ofteno Only occasionallyo No, never

*5 I have felt scared or panicky for no very good reasono Yes, quite a loto Yes, sometimeso No, not mucho No, not at all

*10 The thought of hanning myself has occurred to meo Yes, quite ofteno Sometimeso Hardly evero Never

Administered/Reviewed by Date _

1 Source: Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-itemEdinburgh Postnatal Depression Scale. British Journal of Psychiatry 150:782-786.2 Source: K. L. Wisner, B. L. Parry, C. M. Piontek, Postpartum Depression N Engl J Med vol. 347, No 3, July 18, 2002,194-199Users may reproduce the scale without further pennission providing they respect copyright by quoting the names of theauthors, the title and the source of the paper in all reproduced copies.

PATIENT NAME DATE OF BIRTli

M-CHAT

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Please fill out the following about how your child usually is. Please try to answer every question. If the behavior israre (e.g., you've seen it once or twice), please answer as ifthe child does not do it.

1. Does your child enjoy being swung, bounced on your knee, etc.?

2. Does your child take an interest in other children?

3. Does your child like climbing on things, such as up stairs?

4. Does your child enjoy playing peek-a-boo/hide-and-seek?

5. Does your child ever pretend, for example, to talk on the phone or take care of a doll orpretend other things?

6. Does your child ever use his/her index finger to point, to ask for something?

7. Does your child ever use his/her index finger to point, to indicate interest in something?

8. Can your child play properly with small toys (e. g. cars or blocks) without justmouthing, fiddling, or dropping them?

9. Does your child ever bring objects over to you (parent) to show you something?

10. Does your child look you in the eye for more than a second or two?

11. Does your child ever seem oversensitive to noise? (e.g., plugging ears)

12. Does your child smile in response to your face or your smile?

13. Does your child imitate you? (e.g., you make a face-will your child imitate it?)

14. Does your child respond to his/her name when you call?

15. If you point at a toy across the room, does your child look at it?

16. Does your child walk?

17. Does your child look at things you are looking at?

18. Does your child make unusual finger movements near his/her face?

19. Does your child try to attract your attention to his/her own activity?

20. Have you ever wondered if your child is deaf?

21. Does your child understand what people say?

22. Does your child sometimes stare at nothing or wander with no purpose?

23. Does your child look at your face to check your reaction when faced withsomething unfamiliar?

© 1999 Diana Robins, Deborah Fein, & Marianne Barton

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Please fefer to Robins, D., Fein, D., Barton, M., & Green, j. (2001). The Modified Checklist for Autism in Toddlers: Aninitial stury investigating the early detection of autism and pervasive developmental disorders.

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