Depression

Question 1

what is baby blues

Answer 1

Baby blues is seen in the majority of women in the first week or so after birth

Question 2

what is postnatal depression

Answer 2

seen in about one in ten women, with a peak around three months after birth

Question 3

what is peurpural psychosis?

Answer 3

is seen in about one in a thousand women, starting a few weeks after birth

Question 4

postnatal depression features

Answer 4

Low mood
Anhedonia (lack of pleasure in activities)
Low energy

Question 5

postnatal depression treatment

Answer 5

Mild cases may be managed with additional support, self-help and follow up with their GP
Moderate cases may be managed with antidepressant medications (e.g. SSRIs) and cognitive behavioural therapy
Severe cases may need input from specialist psychiatry services, and rarely inpatient care on the mother and baby unit

Question 6

screening for postnatal depression

Answer 6

Edinburgh Postnatal Depression Scale > 10

Question 7

Treatment of depression in children?

Answer 7

Mild depression or low mood associated with a single negative event (e.g. loss of a family member) can be managed with watchful waiting and advice about healthy habits, such as healthy diet, exercise and avoiding alcohol and cannabis. Follow up within 2 weeks is advised.

NICE recommend referral to CAMHS for children with moderate to severe depression. CAMHS can then initiate:

Full assessment to establish a diagnosis
Psychological therapy as the first line treatment with cognitive behavioural therapy, non-directive supportive therapy, interpersonal therapy and family therapy
Fluoxetine is the first line antidepressant in children, starting at 10mg and increasing to a maximum of 20mg
Sertraline and citalopram are second line antidepressants
When the child responds to medical treatment, it should continue 6 months after remission is achieved
When they do not respond to medical treatment they may require intensive psychological therapy
Where there is follow up monitoring in secondary care, the mood and feelings questionnaire (MFQ) may be used to assess progress.

Admission may be required where there is high risk of self harm, suicide or self-neglect or where they may be an immediate safeguarding issue.

Question 8

Screening for Depression

Answer 8

HAD and PHQ9