Mental Health Flashcards
What percentage of pregnant women are affected by psychiatric disorders
How many require input from perinatal services
20%
3-5% require input
How many maternal deaths from 6 weeks to one year are due to a psychiatric cause
25%
When is the peak onset for puerperal psychosis
Day <7 days
50% by day 7
75% by day 16
95% by day 90
Can begin in labour
What is the risk of puerperal psychosis with a Hx of bipolar
25-30%
What is the risk of puerperal psychosis with a Hx of bipolar and a FHx of puerperal psychosis
74%
What is the risk of postpartum depression with a Hx or depression and a FHx of postpartum depression
40%
What % of pregnant women have depression
12%
What % of pregnant women have anxiety
13%
What % of women suffer with anxiety and depression in the first year after childbirth
15-20%
What is the incidence of postpartum psychosis
2:1000
What is the incidence of severe depressive illness
30:1000
What is the incidence of PTSD
30:1000
What is the incidence of mild/moderate depression and anxiety
100-150:1000
If a woman answers yes to whooleys depression screen what should be done
Edinburgh depression scale
What score on the Edinburgh depression scale would require further assessment
What is it’s positive and negative predictive value
Score >12
positive predictive value 57%
negative predictive value
99%
Postnatal blues
How common are they
50-80%
Postnatal blues
When do they usually occur, when do they peak and for how long do they last
Day 3-10
Peak D5
48hr self limiting
In regards to postpartum depression
What percentage are still symptomatic at >1yr
30%
In regards to postpartum depression
What is the incidence overall and in the first 3 months
11%
13% in the first 3 months
In regards to postpartum depression
How many women develop symptoms antenatally
50%
In regards to postpartum depression
What is the biggest risk factor
Previous psychiatric history
FHx also significant
In regards to postpartum depression
When does it occur
2 peaks
Day 2-4
Day 10-14
In regards to postpartum depression
What is the risk of recurrence
1:2 to 1:3
In regards to postpartum depression
What is the treatment if mild-moderate
Low intensity psychological input
Facilitated self help
In regards to postpartum depression
What is the treatment if moderate-severe
High intensity psychological input
SSRI/SNRI/TCA
Combination
In regards to postpartum depression
What is the treatment if severe
Switching antidepressant
Antipsychotics
Mood stabilisers
ECT
What % of the population is affected by bipolar
1%
Regarding bipolar disorder
What is the mean age of onset
17-22yr
Regarding bipolar disorder
At what gestation should a birth plan be made
32 weeks
Regarding bipolar disorder
What is the risk of puerperal psychosis with a previous episode
> 50%
What is the risk of recurrence of puerperal psychosis and how should it be managed
50%
Consider elective admission to mother and baby unit
In regards to puerperal psychosis
What % go on to develop bipolar
35-65%
What period is highest risk for suicide
Late pregnancy and first 12 weeks postpartum
Regarding puerperal psychosis
How common is suicide
2:100
By how much does anorexia increase the risk of maternal mortality
6x
What is the first line treatment for a woman with a Hx of severe depression that develops mild depression in pregnancy or the postpartum period
Pharmacological treatment
SSRI or TCA
