Mental Health in Pregnancy and Postpartum

Question 1

What are the baby blues?

Answer 1

A mild, transient mood disturbance experienced by women after childbirth, characterized by emotional lability and low mood.

Question 2

When do the baby blues typically occur?

Answer 2

Within the first few days postpartum, peaking around day 3–5 and usually resolving by day 10.

Question 3

What are the common symptoms of the baby blues?

Answer 3

Tearfulness.
Irritability.
Mood swings.
Fatigue.
Feelings of overwhelm.
Anxiety or mild low mood.

Question 4

The baby blues typically resolves within __________ days postpartum without the need for medical intervention.

Answer 4

10

Question 5

What causes the baby blues?

Answer 5

Hormonal changes after childbirth, particularly the sudden drop in estrogen and progesterone, combined with the stress and exhaustion of caring for a newborn.

Question 6

True/False
Q: The baby blues is considered a mental health disorder requiring long-term treatment.

Answer 6

False (it is a transient and normal response to childbirth).

Question 7

What are the risk factors for experiencing the baby blues?

Answer 7

First-time motherhood.
History of mood disorders.
Stressful delivery or lack of social support.
Sleep deprivation.

Question 8

What is the management for the baby blues?

Answer 8

Reassurance: It is common and usually resolves without intervention.
Emotional support: Encourage open discussion with family and friends.
Promote rest and self-care.

Question 9

How can you differentiate the baby blues from postpartum depression?

Answer 9

Baby Blues: Mild, starts within a few days postpartum, resolves by day 10.
Postpartum Depression: More severe, persists beyond 2 weeks, includes significant functional impairment and possibly suicidal thoughts.

Question 10

Baby blues is a __________ postpartum condition that does not require medical treatment.

Answer 10

Self-limiting

Question 11

A new mother presents with tearfulness, irritability, and feeling overwhelmed at day 4 postpartum. Symptoms have been mild and started on day 2. What is the most likely diagnosis?

Answer 11

Baby blues.

Question 12

What are the key takeaways about the baby blues?

Answer 12

It is a normal physiological response to childbirth.
Symptoms are transient and self-limiting.
Emotional support and reassurance are the mainstays of management.

Question 13

What is obstetric depression?

Answer 13

Depression occurring during pregnancy (antenatal) or after childbirth (postnatal), affecting the emotional and functional well-being of the mother.

Question 14

What is the prevalence of postnatal depression?

Answer 14

Affects 10-15% of mothers within the first year postpartum.

Question 15

What are the risk factors for obstetric depression?

Answer 15

History of depression or other mental health disorders.
Lack of social support.
Stressful life events or relationship problems.
Complications during pregnancy or childbirth.
Premature birth or illness in the baby.

Question 16

What are the symptoms of obstetric depression?

Answer 16

Persistent low mood or sadness.
Loss of interest or anhedonia.
Fatigue and low energy.
Poor concentration or indecisiveness.
Sleep disturbances (insomnia or hypersomnia).
Appetite changes.
Feelings of guilt or worthlessness.
Thoughts of self-harm or suicide.

Question 17

Obstetric depression is diagnosed when symptoms persist for at least __________ weeks and impact daily functioning.

Answer 17

2

Question 18

How can you differentiate postnatal depression from the baby blues?

Answer 18

Baby Blues: Mild, transient, resolves by day 10 postpartum.
Postnatal Depression: Persistent symptoms lasting >2 weeks, affecting daily life and bonding with the baby.

Question 19

What tools are used for screening obstetric depression?

Answer 19

Edinburgh Postnatal Depression Scale (EPDS).
Patient Health Questionnaire (PHQ-9).

Question 20

True/False
Q: The Edinburgh Postnatal Depression Scale (EPDS) is validated for use during pregnancy and postpartum.

Answer 20

true.

Question 21

What are the management options for obstetric depression?

Answer 21

Psychological therapies:
Cognitive-behavioral therapy (CBT).
Interpersonal therapy (IPT).
Medication:
Antidepressants (e.g., SSRIs such as sertraline or fluoxetine).
Lifestyle:
Adequate rest, exercise, and nutrition.
Support groups or peer support.
Specialist input if severe or associated with psychosis.

Question 22

_________ are the first-line pharmacological treatment for obstetric depression, especially during breastfeeding.

Answer 22

SSRIs

Question 23

What are the potential complications of untreated obstetric depression?

Answer 23

Poor maternal-infant bonding.
Delayed infant development.
Relationship breakdowns.
Risk of self-harm or suicide.
Increased risk of future depressive episodes.

Question 24

A 30-year-old mother presents 4 weeks postpartum with persistent low mood, tearfulness, and loss of interest in activities. She struggles to bond with her baby and reports insomnia. What is the likely diagnosis, and how should she be managed?

Answer 24

Diagnosis: Postnatal Depression.
Management: Psychological therapies (e.g., CBT) and consider SSRIs if symptoms are moderate to severe.

Question 25

Why is sertraline considered the preferred SSRI for breastfeeding mothers?

Answer 25

It has a low transfer rate into breast milk and minimal adverse effects on the infant.

Question 26

How can obstetric depression be prevented?

Answer 26

Early identification of at-risk women. Regular antenatal mental health screening. Strengthening social support networks. Education about normal postnatal emotional changes.

Question 27

Match the type of depression with its characteristic: Baby Blues Postnatal Depression Postpartum Psychosis a. Severe mood swings with psychotic features. b. Mild mood changes resolving within 10 days. c. Persistent low mood and anhedonia lasting >2 weeks.

Answer 27

1-b, 2-c, 3-a

Question 28

What is postpartum depression (PPD)?

Answer 28

A depressive disorder occurring within the first year postpartum, characterized by persistent low mood, loss of interest, and functional impairment.

Question 29

How common is postpartum depression?

Answer 29

Affects approximately 10-15% of mothers.

Question 30

When does postpartum depression typically begin?

Answer 30

Symptoms can start any time within the first year postpartum, commonly within the first 6 weeks.

Question 31

List some risk factors for postpartum depression.

Answer 31

History of depression or other mental health disorders. Lack of social support. Stressful life events or financial stress. Complications during pregnancy or delivery. Premature birth or neonatal illness. Sleep deprivation.

Question 32

The peak onset of postpartum depression is typically within the first __________ weeks postpartum.

Answer 32

6

Question 33

What are the key symptoms of postpartum depression?

Answer 33

Persistent low mood or sadness. Loss of interest (anhedonia). Irritability or anger. Fatigue or low energy. Sleep disturbances (insomnia or hypersomnia). Poor appetite or overeating. Feelings of guilt or worthlessness. Difficulty bonding with the baby. Thoughts of self-harm or suicide.

Question 34

How can you differentiate postpartum depression from baby blues?

Answer 34

Baby Blues: Mild, transient, resolves by day 10 postpartum. Postpartum Depression: Persistent, lasting >2 weeks, and interferes with functioning.

Question 35

Which tools are used to screen for postpartum depression?

Answer 35

Edinburgh Postnatal Depression Scale (EPDS). Patient Health Questionnaire (PHQ-9).

Question 36

True/False Q: Postpartum depression always resolves without treatment.

Answer 36

False (it often requires intervention and support).

Question 37

What are the management options for postpartum depression?

Answer 37

Psychological therapies: Cognitive-behavioral therapy (CBT). Interpersonal therapy (IPT). Pharmacological therapies: SSRIs (e.g., sertraline, fluoxetine). Lifestyle changes: Encourage rest and support from family or friends. Support groups. Specialist referral if severe or if psychotic features are present.

Question 38

A 28-year-old new mother presents 4 weeks postpartum with persistent sadness, poor sleep, and difficulty bonding with her baby. She feels guilty about her parenting abilities and has thoughts of self-harm. What is the likely diagnosis and appropriate management?

Answer 38

Diagnosis: Postpartum Depression. Management: CBT and consider SSRIs if symptoms are moderate to severe.

Question 39

The __________ scale is specifically designed to screen for postpartum depression.

Answer 39

Edinburgh Postnatal Depression Scale (EPDS).

Question 40

What are the complications of untreated postpartum depression?

Answer 40

Poor maternal-infant bonding. Delayed infant development. Increased risk of future depressive episodes. Potential for self-harm or suicide.

Question 41

What is the prognosis for postpartum depression?

Answer 41

Excellent with appropriate treatment. Untreated depression can persist for months and impact maternal and infant health.

Question 42

What is puerperal psychosis?

Answer 42

A rare and severe psychiatric condition that occurs shortly after childbirth, involving psychosis with symptoms like delusions, hallucinations, and disorganized thinking.

Question 43

How common is puerperal psychosis?

Answer 43

Affects approximately 1-2 per 1,000 births.

Question 44

When does puerperal psychosis typically occur?

Answer 44

Usually within the first 2 weeks postpartum, but it can present up to 6 weeks postpartum.

Question 45

What are the risk factors for puerperal psychosis?

Answer 45

Personal or family history of bipolar disorder or psychosis. First pregnancy. Traumatic birth or obstetric complications. Lack of social support. Previous episode of puerperal psychosis.

Question 46

Women with a history of __________ are at significantly higher risk of developing puerperal psychosis.

Answer 46

Bipolar disorder

Question 47

What are the clinical features of puerperal psychosis?

Answer 47

Delusions: Fixed false beliefs, often about the baby. Hallucinations: Auditory or visual. Severe mood disturbances: Mania or depression. Disorganized thoughts and behaviors. Poor insight and judgment. Risk of harm to self or baby.

Question 48

How does puerperal psychosis differ from postnatal depression?

Answer 48

Puerperal psychosis includes psychotic symptoms like delusions and hallucinations. Postnatal depression is primarily characterized by low mood and anhedonia without psychosis.

Question 49

What is the basis for diagnosing puerperal psychosis?

Answer 49

Clinical diagnosis based on history and presentation. Exclude organic causes (e.g., encephalopathy, substance use, or infection).

Question 50

True/False Q: Puerperal psychosis is a psychiatric emergency requiring immediate intervention.

Answer 50

true.

Question 51

What are the management options for puerperal psychosis?

Answer 51

Urgent psychiatric referral: Consider inpatient admission to a mother-and-baby unit. Pharmacological treatment: Antipsychotics (e.g., olanzapine). Mood stabilizers (e.g., lithium). Antidepressants if depressive symptoms predominate. Electroconvulsive therapy (ECT): For severe or resistant cases. Supportive care: Family support and monitoring. Ensuring safety of the mother and baby.

Question 52

A 32-year-old woman presents 10 days postpartum with delusions that her baby is possessed, auditory hallucinations, and severe insomnia. She has a history of bipolar disorder. What is the likely diagnosis, and how should she be managed?

Answer 52

Diagnosis: Puerperal Psychosis. Management: Urgent psychiatric referral, likely inpatient care, and treatment with antipsychotics or mood stabilizers.

Question 53

What are the potential complications of untreated puerperal psychosis?

Answer 53

Risk of harm to self or baby. Long-term psychiatric illness (e.g., bipolar disorder). Poor maternal-infant bonding.

Question 54

What is the prognosis for puerperal psychosis?

Answer 54

Good with early diagnosis and treatment. Most women recover fully but are at risk of recurrence in future pregnancies.

Question 55

_________ therapy may be used in severe cases of puerperal psychosis that are resistant to medication.

Answer 55

Electroconvulsive (ECT)