EPDS Interpretation — MRCPsych Paper B MCQ

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EasyPerinatal PsychiatryEPDS InterpretationMRCPsych Paper B

A woman 8 weeks after childbirth completes the 10-item Edinburgh Postnatal Depression Scale (EPDS). Her total score is 10, with no endorsement of the self-harm item. Using the commonly applied threshold of 10 or above, which is the most accurate interpretation?

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Correct answer: D — Possible depression requiring clinical assessment

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · B = shown as D · A = shown as E

The correct answer is B. The EPDS is a 10-item self-report screening instrument, not a diagnostic interview. A score of 10 or above is a commonly used threshold indicating that depression is possible and that clinical assessment is required, including symptom duration, functional impairment, differential diagnosis and risk. NICE recommends using the EPDS as part of a full assessment or for monitoring rather than diagnosing depression from the score alone. Therefore, option A overstates the result. Option C incorrectly treats the score as reassuring. The EPDS does not diagnose postpartum psychosis or personality disorder, so options D and E are incorrect. Any endorsement of the self-harm item would require separate risk assessment regardless of the total score.

Reference: Levis B et al. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women. BMJ 2020;371:m4022. https://www.nice.org.uk/guidance/cg192/chapter/Recommendations