Mental illness in pregnancy and the postnatal period

Question 1

Risk of depression during pregnancy

Answer 1

10%

Question 2

Percentage of new psychiatric episodes in the postpartum period which are mood disorders

Answer 2

80%

Question 3

Relapse rate of depression while pregnant in women with previous depression

Answer 3

50%

Question 4

Risk of postpartum psychosis in the general population

Answer 4

1-2 in 1000

Question 5

Risk of postpartum psychosis in women with bipolar affective disorder

Answer 5

20-50%

Question 6

Risk of postpartum psychosis in women with previous postpartum psychosis

Answer 6

50-90%

Question 7

Increased relative risk of psychosis in the first postpartum month

Answer 7

20x increase

Question 8

Percentage of women who experience baby blues

Answer 8

75%

Question 9

Percentage of women who experience postpartum depression

Answer 9

4-20%

Question 10

Intervention required for baby blues

Answer 10

None

Question 11

Typical timing of baby blues

Answer 11

Days 2-5 post delivery

Question 12

Common clinical picture in postpartum psychosis compared to other psychotic episodes

Answer 12

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

Question 13

Typical timing of postpartum psychosis

Answer 13

First two weeks after delivery

Question 14

Percentage of cases of postpartum psychosis where infantacide occurs

Answer 14

1-4.5%

Question 15

Percentage of women with postpartum psychosis who have no history of severe psychiatric illness

Answer 15

40%

Question 16

Obstetric factor most associated with postpartum psychosis

Answer 16

Primiparity

Question 17

Percentage of women with postpartum psychosis who have a positive family history of mood disorders among first and second degree relatives

Answer 17

40-50%

Question 18

Hormone changes thought to be related to the development of postpartum psychosis

Answer 18

Loss of oestrogen and progesterone after birth

Question 19

Increased risk of relapse when antidepressants are stopped during pregnancy, compared to when they are continued

Answer 19

5x higher risk if antidepressants are stopped

Question 20

Length of time postpartum where there is a significant increase in new psychiatric episodes

Answer 20

3 months

Question 21

Percentage of women with history of depression who relapse if antidepressants are discontinued during pregnancy

Answer 21

2-8%

Question 22

Most likely mood episode in women with a history of bipolar disorder after delivery

Answer 22

Depression

Question 23

Percentage of patients with schizophrenia who experience a relapse of psychosis in the first 12 months postpartum

Answer 23

16%

Question 24

Effect of pregnancy on suicide rates

Answer 24

Lower

Question 25

Effect of pregnancy on depression rates

Answer 25

Higher

Question 26

Effect of pregnancy on anxiety rates

Answer 26

Higher

Question 27

Risk of a spontaneous major malformation in a confirmed pregnancy

Answer 27

2-4%

Question 28

Most common symptom of postpartum psychosis

Answer 28

Affective symptoms