MBBS MD FRANZCOG DDU (ASUM)
Edinburgh Depression Scale Form
Today's Date 30/06/2026
Weeks Pregnant
or Weeks Postnatal
Patient Name *
Title
First *
Last *
Please select one option for each question that is the closest to how you have felt in the PAST SEVEN DAYS.
1. I have been able to laugh and see the funny side of things: * As much as I always couldNot quite as much nowDefinitely not so much nowNot at all
2. I have looked forward with enjoyment to things: * As much as I ever didRather less than I used toDefinitely less than I used toHardly at all
3. I have blamed myself unnecessarily when things went wrong: * Yes, most of the timeYes, some of the timeNot very oftenNo, never
4. I have been anxious or worried for no good reason: * No, not at allHardly everYes, sometimesYes, very often
5. I have felt scared or panicky for no very good reason: * Yes, quite a lotYes, sometimesNo, not muchNo, not at all
6. Things have been getting on top of me: * Yes, most of the time I haven't been able to cope at allYes, sometimes I haven't been coping as well as usualNo, most of the time I have coped quite wellNo, I have been coping as well as ever
7. I have been so unhappy that I have had difficulty sleeping: * Yes, most of the timeYes, sometimesNot very oftenNo, not at all
8. I have felt sad or miserable: * Yes, most of the timeYes, quite oftenNot very oftenNo, not at all
9. I have been so unhappy that I have been crying: * Yes, most of the timeYes, quite oftenOnly occasionallyNo, never
10. The thought of harming myself has occurred to me: * Yes, quite oftenSometimesHardly everNever
NOTE: If you have had ANY thoughts of harming yourself, please tell your GP or your midwife today.
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