Exam 2 - Perinatal Mental Health Flashcards
___% of birthing persons experience some kind of mood disturbance postpartum
85
the 3 subclasses of postpartum psychiatric disorders are
(1) baby blues
(2) postpartum major mood disorders
(3) postpartum psychosis
____ is considered a medical emergency
postpartum psychosis
Transient period of “depression”
baby blues
_____ may be d/t hormonal fluctuations, sleep deprivation, and role change
baby blues
when does baby blues peak?
3-5 days after delivery
baby blues usually resolves ____
10-12 days postpartum
symptoms of baby blues are
(1) mood lability
(2) anxiety
(3) sleeplessness
(4) crying
(5) loss of appetite
baby blues is a risk factor for ___
postpartum depression
the biggest role for the nurse in baby blues is
education
4 pieces of education a nurse can provide for someone with baby blues include
(1) s/s of depression
(2) provide resources
(3) discuss sleep hygiene
(4) discuss infant behavioral regulation
major/minor depressive episodes that occur during pregnancy or the first 12 months after birth
perinatal depression
Psychiatric illness in which patients experience one or more major depressive episodes that include (1) 2 weeks or longer; (2) functional impairment; (3) 5 or more symptoms
DSM-5 MDD diagnosis
Name at least 3 symptoms of MDD
(1) depressed mood
(2) diminished interest or pleasure (anhedonia)
(3) changes in weight
(4) insomnia or hypersomnia
(5) psychomotor agitation or retardation
(6) fatigue
(7) poor concentration
(8) suicidal ideation
Name at least 3 risk factors for perinatal depression
(1) maternal anxiety
(2) life stress
(3) h/o depression
(4) lack of social support
(5) unintended pregnancy
(6) domestic violence
(7) lower income / Medicaid insurance
(8) smoking
(9) single status
_____ is the biggest risk factor for postpartum depression
depression during pregnancy
breastfeeding problems are a risk factor for
postpartum depression
preterm birth or infant admission to NICU puts the mom at risk for
postpartum depression
name at least 3 risks to the infant being exposed to recurrent or postpartum depression
(1) impaired bonding
(2) impaired emotional development
(3) language impairment
(4) impaired attn
(5) impaired cognitive skills
(6) impaired parenting behavior
you are more likely to have postpartum depression, rather than baby blues if…
(1) h/o mood d/o before postpartum
(2) more severe symptoms
(3) symptoms are lasting longer
EPDS is a tool to ___
screen for perinatal depression
the most common pharmacologic treatment for postpartum depression is
sertraline / zoloft
why is sertraline the preferred med for postpartum depression?
(1) safe during pregnancy and breastfeeding
(2) can titrate the dose
(3) often taken during pregnancy
sertraline can cause ____ to neonates at birth
respiratory depression (transient)
what is the most important thing to do to for the pt with pharmacologic tx?
counsel the pt on risk and benefit
name 3 other common drugs used for postpartum depression tx
celexa, lexapro, prozac, paxil
postpartum psychosis risk factors
(1) bipolar disorder
(2) h/o postpartum psychosis
(3) family h/o psychotic illness
(4) cessation of meds for bipolar
(5) sleep deprivation
(6) prior pregnancy loss
postpartum psychosis s/s
manic/mixed episode that includes decreased sleep, psychosis, and agitation
___% of pts with postpartum psychosis will relapse
80
How can we assess pts with concern for harming their infant?
(1) obsessions
(2) ego-dystonic vs ego-systonic thoughts
(3) intent and plan
(4) psychosis
(5) suicidal thoughts
name the key parts of treatment for postpartum psychosis
(1) hospitalization
(2) initiation of meds
(3) sleep hygiene
(4) preventative plan in place
anxiety disorders risk factors
(1) younger
(2) female
(3) minimal social support
(4) family h/o anxiety disorder
____ is the most common psychiatric condition in postpartum
anxiety
perinatal anxiety disorder includes
(1) GAD
(2) OCD
(3) PTSD
(4) depression and anxiety together
when can a mother develop perinatal anxiety?
(1) immediately after delivery through 6 weeks
(2) during pregnancy
(3) weaning or return of menses
(4) undiagnosed
(5) fear, anxiety, stress
s/s of postpartum GAD
(1) constant worry
(2) feeling that something bad will happen
(3) racing thoughts
(4) disturbances of sleep and appetite
(5) inability to sit still
(6) physical symptoms
Repetitive, intrusive images and thoughts that are frightening and can feel like they “come out of the blue”
perinatal OCD
intrusive thoughts, which are persistent, repetitive thoughts or images related to the baby that are upsetting
obsessions
postpartum person may do certain things over and over again to reduce her fears and obsessions
compulsions
how do you treat perinatal OCD?
CBT and medication
____ occrs after the patient perceives childbirth to be traumatic
perinatal PTSD
perinatal PTSD presents itself as
nightmares, flashback, avoiding reminders of the event, and depression
patients who have a birth very different from their expectations or desires can be at risk for ___
perinatal PTSD
what is the treatment for perinatal PTSD?
pt should talk through their experiences and how they perceived them
the main four types of therapy for mood and anxiety disorders are
(1) therapy
(2) medication
(3) lifestyle changes
(4) integrative therapies
