Origins of the EPDS

In the early 1980s, the limitations of existing self-report questionnaires for use in community samples were beginning to be recognised. Philip Snaith (1983), for example, had acknowledged the need to modify existing scales for use in specialist settings; and Channi Kumar (1982), in Motherhood and Mental Illness, recognised there was a need for

In Edinburgh at that time the serious limitations of existing self-report scales had become very apparent to us. Although we used the best available scale in our prospective study (Cox, 1983) – the Anxiety and Depression Questionnaire (SAD) of Bedford & Foulds (1978) – and although it had the advantage of brevity and few somatic items, it failed to detect any increase in these symptoms in the first postpartum weeks, and the recommended cut-off score was completely inappropriate for use during pregnancy (Cox, 1983). Of the 13 pregnant women with a score of 6+, only 3 had any form of mental disorder, and some items lacked face validity for childbearing women. We concluded:

The intent of the grant application to the Scottish Home and Health Department in 1983 was therefore to develop and validate a screening scale specifically for use with childbearing women in the community, and also to carry out an intervention study by health visitors.