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Isleans Mrcog Part 2 > Mental Health > Flashcards

Mental Health Flashcards

1
Q

What percentage of pregnant women are affected by psychiatric disorders

How many require input from perinatal services

A

20%

3-5% require input

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2
Q

How many maternal deaths from 6 weeks to one year are due to a psychiatric cause

A

25%

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3
Q

When is the peak onset for puerperal psychosis

A

Day <7 days

50% by day 7
75% by day 16
95% by day 90

Can begin in labour

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4
Q

What is the risk of puerperal psychosis with a Hx of bipolar

A

25-30%

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5
Q

What is the risk of puerperal psychosis with a Hx of bipolar and a FHx of puerperal psychosis

A

74%

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6
Q

What is the risk of postpartum depression with a Hx or depression and a FHx of postpartum depression

A

40%

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7
Q

What % of pregnant women have depression

A

12%

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8
Q

What % of pregnant women have anxiety

A

13%

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9
Q

What % of women suffer with anxiety and depression in the first year after childbirth

A

15-20%

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10
Q

What is the incidence of postpartum psychosis

A

2:1000

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11
Q

What is the incidence of severe depressive illness

A

30:1000

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12
Q

What is the incidence of PTSD

A

30:1000

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13
Q

What is the incidence of mild/moderate depression and anxiety

A

100-150:1000

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14
Q

If a woman answers yes to whooleys depression screen what should be done

A

Edinburgh depression scale

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15
Q

What score on the Edinburgh depression scale would require further assessment

What is it’s positive and negative predictive value

A

Score >12

positive predictive value 57%
negative predictive value
99%

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16
Q

Postnatal blues

How common are they

A

50-80%

17
Q

Postnatal blues

When do they usually occur, when do they peak and for how long do they last

A

Day 3-10
Peak D5

48hr self limiting

18
Q

In regards to postpartum depression

What percentage are still symptomatic at >1yr

A

30%

19
Q

In regards to postpartum depression

What is the incidence overall and in the first 3 months

A

11%

13% in the first 3 months

20
Q

In regards to postpartum depression

How many women develop symptoms antenatally

A

50%

21
Q

In regards to postpartum depression

What is the biggest risk factor

A

Previous psychiatric history

FHx also significant

22
Q

In regards to postpartum depression

When does it occur

A

2 peaks

Day 2-4
Day 10-14

23
Q

In regards to postpartum depression

What is the risk of recurrence

A

1:2 to 1:3

24
Q

In regards to postpartum depression

What is the treatment if mild-moderate

A

Low intensity psychological input

Facilitated self help

25
Q

In regards to postpartum depression

What is the treatment if moderate-severe

A

High intensity psychological input

SSRI/SNRI/TCA

Combination

26
Q

In regards to postpartum depression

What is the treatment if severe

A

Switching antidepressant
Antipsychotics
Mood stabilisers
ECT

27
Q

What % of the population is affected by bipolar

A

1%

28
Q

Regarding bipolar disorder

What is the mean age of onset

A

17-22yr

29
Q

Regarding bipolar disorder

At what gestation should a birth plan be made

A

32 weeks

30
Q

Regarding bipolar disorder

What is the risk of puerperal psychosis with a previous episode

A

> 50%

31
Q

What is the risk of recurrence of puerperal psychosis and how should it be managed

A

50%

Consider elective admission to mother and baby unit

32
Q

In regards to puerperal psychosis

What % go on to develop bipolar

A

35-65%

33
Q

What period is highest risk for suicide

A

Late pregnancy and first 12 weeks postpartum

34
Q

Regarding puerperal psychosis

How common is suicide

A

2:100

35
Q

By how much does anorexia increase the risk of maternal mortality

A

6x

36
Q

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

A

Pharmacological treatment

SSRI or TCA

Isleans Mrcog Part 2 (26 decks)

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