BMB 3 - Female Mental Health Flashcards
‘Postpartum depression’ is something of a catchall phrase used to describe what disorders?
Depression in pregnancy and postpartum
Bipolar mood disorder (postpartum psychosis)
Anxiety in pregnancy and postpartum (OCD, panic, GAD, PTSD)
The ‘baby blues’/postpartum blues occur during a 2-week period in which which women are vulnerable?
EVERY woman’s brain
A patient experienced depressed mood following childbirth that lasted about 1.5 weeks. Was this postpartum depression?
No.
< 2 weeks is postpartum ‘blues’
> 2 weeks is postpartum depression
Describe the dangers of postpartum psychosis.
5% risk of suicide; 4-6% risk of infanticide
(80% of these are mixed bipolar disorders)
Postpartum PTSD is most likely in what scenarios?
Women who have experienced a previous trauma (such as rape or sexual abuse)
Women who have experienced a physical complication or injury related to pregnancy or childbirth
Baby going to NICU
Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery
A woman presents with recurrent ego-dystonic thoughts about killing or otherwise harming her new baby. Is this likely to be postpartum psychosis?
No.
Postpartum OCD
How does postpartum ‘scary thoughts’ differ from postpartum OCD?
Scary thoughts - Ego-syntonic (believed to be in line with reality: thoughts like “what if I burn the baby in the bath?;” visions of baby falling down the stairs; or impulses “what if I can’t help it and I hurt my baby?”)
(Anxiety or distress over these thoughts is a good sign.)
How serious is postpartum psychosis?
It is a pediatric emergency
Is postpartum psychosis ego-syntonic or ego-dystonic?
Ego-syntonic (believed to be in-line with reality)
List a few protective factors against peripartum mood/anxiety disorders.
Having sufficient autonomy to exercise control in response to severe events
Access to material resources that allow the possibility of making choices in the face of severe events
Psychological support from family, friends or health providers is powerfully protective
List a few psychosocial risk factors for peripartum mood/anxiety disorders.
Sexual violence and subsequent PTSD (real or perceived trauma)
PTSD secondary to childbirth trauma
Unremitting responsibility for others (other children, etc.), pressures created by multiple roles, heavy work-loads
List a few biological risk factors for peripartum mood/anxiety disorders.
Personal or family psychiatric history
Hormonal sensitivity history
Past traumatic births, trauma, losses
Thyroid issues
Describe hormonal sensitivity history as a risk factor for peripartum mood/anxiety disorders.
Reproductive hormones are neuro-modulatory (estrogen is a natural MAOI; therefore, when the estrogen plummets after birth, women can enter a state of estrogen-deplete depression)
First menses (anecdotal evidence shows that one is more likely to have peripartum mood disorders if she had symptoms of anxiety/depression when she got her first menses)
A psychiatric event in first month postpartum predicts conversion to ________ in 15-year follow-up.
A psychiatric event in first month postpartum predicts conversion to bipolar in 15-year follow-up.
Severe psychiatric events are more likely within the first ___-___ days after childbirth. Women with chronic _________ illness are more likely to develop peripartum mood/anxiety disorders as well.
Severe psychiatric events are more likely within the first 30 - 90 days after childbirth. Women with chronic mental illness are more likely to develop peripartum mood/anxiety disorders as well.
