Disorders of the puerperium Flashcards
What is the puerperium?
6 week period following pregnancy
What are some possible causes of mental health disorders in the puerperium?
- Loss of independence
- Hormonal changes
- Unremitting demands
- Chronic loss of sleep
What are the 2 main mental health disorders of the puerperium
Puerperal psychosis
Post-natal depression
What is puerperal psychosis?
Severe mental illness which develops acutely in the early postnatal period, usually within the first month following delivery
How common is puerperal psychosis?
About 1 in 1,000 births
What are some risk factors for puerperal psychosis?
Previous thyroid disorder
Previous episode
Family history
Being unmarried
First pregnancy
C-section
Perinatal death
How does puerperal psychosis present?
Characterised by acute sudden onset of psychotic symptoms, manic symptoms/disinhibition, confusion
How is puerperal psychosis managed?
- requires urgent assessment, referral, and usually admission, ideally to a specialist mother and baby unit
- Medication usually involves an antipsychotic and/or mood stabiliser
What is post-natal depression?
Characterised by low mood in the postnatal period (within first 3 months)
When does post-partum depression usually occur?
Usual onset 1-4 weeks postpartum
What are some risk factors for post-partum depression?
- Family or personal history of depression or anxiety
- Complicated pregnancy
- Traumatic birth
- Relationship difficulties (including domestic violence)
- History of abuse or trauma
- Lack of support
- Financial difficulties
How does post-partum depression present?
- Low mood
- Anhedonia(lack of pleasure in activities)
- Anergia (low energy)
How is mild post-partum depression managed?
Mild casesmay be managed with additional support, self-help and follow up with their GP
How is moderate post-partum depression managed?
Moderate casesmay be managed withantidepressant medications(e.g. SSRIs) andCBT
How is severe post-partum depression managed?
Severe casesmay need input from specialist psychiatry services, and rarely inpatient care on themother and baby unit
