(PDSS) Postpartum Depression Screening Scale

BY CHERYL TATANO BECK, DNSC, AND ROBERT K. GABLE, EDD

Although postpartum depression is not uncommon among new mothers, it often goes undetected. And if untreated, it can adversely affect a mother’s functioning as well as her infant’s development.

A Measure of Overall Severity and Seven Specific Symptoms

With the Postpartum Depression Screening Scale (PDSS), clinicians can identify mothers suffering from postpartum depression—early and easily. This 35-item, self-report instrument can be administered in just 5 to 10 minutes. Used as a brief screening device, it identifies women who are at high risk for postpartum depression, so that health care professionals can then refer them for definitive diagnosis and treatment.

Written at a third-grade reading level, PDSS items are brief and easy to understand. Mothers respond using a 5-point scale ranging from “strongly disagree” to “strongly agree.” The test yields an overall severity score falling into one of three ranges:

Normal adjustment
Significant symptoms of postpartum depression
Positive screen for major postpartum depression

In addition, the PDSS provides scores for seven symptom areas:

• Sleeping/Eating Disturbances
• Anxiety/Insecurity
• Emotional Lability
• Mental Confusion
• Loss of Self
• Guilt/Shame
• Suicidal Thoughts

An Inconsistent Responding Index is also included to measure response validity. Standardization is based on two samples: 525 new mothers of various ethnic backgrounds and 150 women recruited through childbirth classes and newspaper ads prior to giving birth. 

A Quick Gauge of Suicidal Thinking

The first seven items on the scale can function as a Short Form. Completed in just a minute or two, this Short Form provides only a Total Score, though a woman’s response to item seven can be used to gauge her level of suicidal thinking.

Treatment Guidelines

The PDSS can be used across various specialties, including obstetrics, pediatrics, psychiatry, psychology, and social work. It can be administered as early as 2 weeks after delivery. In addition to indicating which mothers need to be referred for a complete diagnostic work-up and treatment, the scale guides and informs treatment by means of the symptom profile it produces. And its brevity and economy make the PDSS ideal for monitoring treatment response.

Given the high incidence of postpartum depression, the current low rate of detection, and the potentially serious consequences, the PDSS is extremely useful in identifying women who need focused attention from mental health professionals.