Perinatal Anxiety Screening Scale
Also known as: PASS
The Perinatal Anxiety Screening Scale (PASS) is a 31-item self-report instrument designed to screen for anxiety symptoms during pregnancy and the postpartum period. Developed by Somerville and colleagues in 2014, it addresses the clinical need for a brief, validated tool that captures the full spectrum of perinatal anxiety disorders, including generalized anxiety, panic, obsessive-compulsive features, and posttraumatic stress in the context of childbirth.
Key highlights
- Captures anxiety-specific symptoms relevant to perinatal populations, not just generic worry.
- Demonstrates strong sensitivity and specificity for detecting clinically significant anxiety disorders in pregnancy and postpartum.
- Brief administration time (5-10 minutes) facilitates integration into routine clinical care.
- Psychometrically sound with published validation in multiple perinatal cohorts.
- Free to use in clinical and research settings without licensing restrictions.
Intuition
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How it works
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When to use it
The PASS is appropriate for routine screening in antenatal clinics and postpartum care settings. It is particularly valuable for early case identification in obstetric practices where mental health resources may be limited. The scale is suitable for women aged 18 and older at any point from early pregnancy through the first postpartum year. It should be used as a screening tool rather than a diagnostic instrument; positive screens require clinical interview and structured assessment by a mental health professional. The PASS is recommended for population health monitoring, research studies examining perinatal anxiety epidemiology, and quality improvement initiatives in maternal mental health.
Strengths & limitations
- Captures anxiety-specific symptoms relevant to perinatal populations, not just generic worry.
- Demonstrates strong sensitivity and specificity for detecting clinically significant anxiety disorders in pregnancy and postpartum.
- Brief administration time (5-10 minutes) facilitates integration into routine clinical care.
- Psychometrically sound with published validation in multiple perinatal cohorts.
- Free to use in clinical and research settings without licensing restrictions.
- Not designed as a diagnostic instrument; clinical confirmation is required for any diagnosis.
- Score interpretation relies on a single severity cutoff; it does not distinguish anxiety subtypes (generalized anxiety, panic disorder, obsessive-compulsive symptoms).
- Validation is primarily in English-speaking populations; cultural adaptation may be needed for diverse populations.
- Does not assess functional impairment or quality-of-life impact; additional assessment may be needed to guide treatment intensity.
Common pitfalls
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Applications
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Frequently asked
What is the difference between the PASS and the EPDS for perinatal screening?
The Edinburgh Postnatal Depression Scale (EPDS) primarily measures depressive symptoms; the PASS is anxiety-specific. Both are brief, validated tools. The PASS captures anxiety symptoms (worry, panic, intrusive thoughts) that the EPDS may miss. Some clinical protocols use both instruments to screen comprehensively for perinatal depression and anxiety.
Can the PASS be used in early pregnancy and late postpartum equally?
Yes, the PASS was designed for use across the full perinatal window from early pregnancy through the postpartum period. Validation studies include both antenatal and postpartum samples. However, anxiety symptom presentation may differ; for example, pregnancy-specific worries dominate in pregnancy while adjustment and infant-related anxiety may feature more prominently postpartum.
Is the PASS copyrighted or freely available?
The PASS is in the public domain and is freely available for clinical and research use without permission or licensing fees. It may be reproduced in full in academic publications and clinical settings.
What should I do if a woman scores ≥26 on the PASS?
A score of 26 or above indicates clinically significant anxiety and warrants further action: a focused clinical interview by a healthcare provider trained in mental health assessment, formal diagnostic evaluation by a mental health professional (psychiatrist, psychologist, or perinatal mental health specialist), and discussion of treatment options (psychotherapy, pharmacotherapy, or both). The woman should be informed of the result and supported in accessing appropriate care.
Sources
- 1.Somerville, S., Dedman, K., Hagan, R., Oxnam, E., Wettinger, M., Byrne, S., Coo, S., Doherty, D. A., & Papagaroufalis, K. (2014). The Perinatal Anxiety Screening Scale (PASS): development and preliminary validation. Archives of Women's Mental Health, 17(5), 443-454.
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Cite this page
ScholarGate. (2026, June 3). Perinatal Anxiety Screening Scale. ScholarGate. https://scholargate.app/obstetrics-gynecology/perinatal-anxiety-screening-scale