Mental illness in pregnancy and the postnatal period Flashcards
Risk of depression during pregnancy
10%
Percentage of new psychiatric episodes in the postpartum period which are mood disorders
80%
Relapse rate of depression while pregnant in women with previous depression
50%
Risk of postpartum psychosis in the general population
1-2 in 1000
Risk of postpartum psychosis in women with bipolar affective disorder
20-50%
Risk of postpartum psychosis in women with previous postpartum psychosis
50-90%
Increased relative risk of psychosis in the first postpartum month
20x increase
Percentage of women who experience baby blues
75%
Percentage of women who experience postpartum depression
4-20%
Intervention required for baby blues
None
Typical timing of baby blues
Days 2-5 post delivery
Common clinical picture in postpartum psychosis compared to other psychotic episodes
Mixed episodes common with manic and depressive episodes occurring together
Often a ‘kaleidoscopic’ picture with constantly changing symptoms
Confusion/perplexity often features
Less likely to have grandiosity
Typical timing of postpartum psychosis
First two weeks after delivery
Percentage of cases of postpartum psychosis where infantacide occurs
1-4.5%
Percentage of women with postpartum psychosis who have no history of severe psychiatric illness
40%
Obstetric factor most associated with postpartum psychosis
Primiparity
Percentage of women with postpartum psychosis who have a positive family history of mood disorders among first and second degree relatives
40-50%
Hormone changes thought to be related to the development of postpartum psychosis
Loss of oestrogen and progesterone after birth
Increased risk of relapse when antidepressants are stopped during pregnancy, compared to when they are continued
5x higher risk if antidepressants are stopped
Length of time postpartum where there is a significant increase in new psychiatric episodes
3 months
Percentage of women with history of depression who relapse if antidepressants are discontinued during pregnancy
2-8%
Most likely mood episode in women with a history of bipolar disorder after delivery
Depression
Percentage of patients with schizophrenia who experience a relapse of psychosis in the first 12 months postpartum
16%
Effect of pregnancy on suicide rates
Lower
Effect of pregnancy on depression rates
Higher
Effect of pregnancy on anxiety rates
Higher
Risk of a spontaneous major malformation in a confirmed pregnancy
2-4%
Most common symptom of postpartum psychosis
Affective symptoms
