Mental health Flashcards
Mental health key principals
effectiveness appropriateness efficiency accessibility continuity responsiveness capability safety sustainability
Tocophobia
fear of pregnancy or childbirth
Tocophobia predisposing factors
sexual abuse termination of pregnancy foetal distress severe pain perineal tearing instrumental/operative birth
Predicting Postnatal Depression
screening in pregnancy
30-40% of women with PND display symptoms in pregnancy
Routine screening - EPNDS (scale)
Management strategies for PND
Psychological therapy and support
Pharmacology
Social support
Complementary therapy
PND Pharmacology
Selective serotonin reuptake inhibitors (SSRI)
– Taken by 5% – 9% of pregnant women & 10% of lactating women
– Increase the extracellular level of serotonin by inhibiting its reuptake into the pre‐synaptic cell, increasing the level of serotonin in the synaptic cleft available to bind to the postsynaptic receptor
• Tricyclics
• Benzodiazepines
• Antipsychotic
Antidepressants during lactation
-only small amounts pass into breast milk
-low dose not assure infant will be unaffected
can delay lactation and inhibit the sucking reflex
Infant can be affected by antidepressants by
Infant blood brain barrier is immature
immature hepatic and renal function
How to improve breast feeding safety?
breast feed immediately before drug intake to minimise infant exposure to medication
give lowest effective dose
observe child for adverse effects
Natural antidepressants
Rhodiola rosea (golden root)
Chromium
Insoital
5-HTP
Effects of maternal depression on infants
passivity anger low weight gain insecure attachment attention and arousal problems
effects of maternal depression on toddlers
passive noncompliance less independence lower performance less interaction with others less creative play
Specific mental health disorders in infancy
feeding and eating disorders pervasive developmental disorders anxiety separation relationship or attachment disorders motor skills disorders
Effects of maternal depression on school age children
impaired adaptive functioning depressive disorders anxiety attention disorders lower IQ
effects of maternal depression on adolescents
depressive disorders anxiety substance use conduct attention learning difficulties
