Mood and Affect Postpartum

Question 1

occurs in approximately 50 to 85 % of women during the first few days after birth and generally continues for up to 10 days.

Answer 1

Postpartum blues

Question 2

type of postpartum psychiatric disorder that is characterized by:

• feelings of sadness
• lack of appetite (anorexia)
• sleep pattern disturbances
• crying easily for no apparent reason
• feelings of inadequacies
• restlessness, fatigue, and insomnia
• headache
• anxiety, anger, sadness
• physical assessment findings: crying

Answer 2

postpartum blues

Question 3

occurs within 6 months of delivery and is characterized by persistent feelings of sadness and intense mood swings. It occurs in 10 to 15% of new mothers and usually does not resolve without intervention. It similar to nonpostpartum mood disorders.

Answer 3

Postpartum depression ( can occur at any time during the first postpartum year)

Question 4

type of postpartum psychiatric disorder that is characterized by:
-feelings of guilt and inadequacies
-irritability
-anxiety
-fatigue persisting beyond a reasonable amount of time
-feeling of loss
-lack of appetite
-persistent feelings of sadness
-intense mood swings
-sleep pattern disturbances
Physical Assessment findings (crying weight loss, flat affect, irritability, rejection of the infant, severe anxiety and panic attack)

Answer 4

Postpartum depression

Question 5

develops within the first 2 to 3 weeks of the postpartum period. Clients who have a history of bipolar disorder are at a higher risk. The client might attempt to harm herself or her infant.

Answer 5

Postpartum psychosis

Question 6

type of postpartum psychiatric disorder that is characterized by:

• pronounced sadness
• disorientation
• confusion
• paranoia
• hallucinations
• delusions

Answer 6

postpartum psychosis

Question 7

What are the risk factors associated with postpartum psychiatric disorder ?

Answer 7

• hormonal changes with a rapid decline in estrogen and progesterone levels
• postpartum physical discomfort or pain
• individual socioeconomic factors
• decreased social support system
• anxiety about assuming new role as mother
• unplanned or unwanted pregnancy
• history of previous depressive disorders
• low self esteem
• history of intimate partner abuse

Question 8

treatment for PPD that are generally considered an option during pregnancy, including citalopram (Celexa), fluoxetine (Prozac) and sertraline (Zoloft). Potential complications include an increased risk of heavy bleeding after giving birth (postpartum hemorrhage), premature birth and low birth weight. Most studies show that _____ aren’t associated with birth defects. However, paroxetine (Paxil) appears to be associated with a small increased risk of a fetal heart defect.

Answer 8

Selective Serotonin Reuptake Inhibitors (SSRIs)

Question 9

treatment for PPD that also are considered an option during pregnancy, including duloxetine (Cymbalta) and venlafaxine (Effexor XR). However, research suggests that taking SNRIs at the end of pregnancy is associated with postpartum hemorrhage.
Bupropion (Wellbutrin).This medication is used for both depression and smoking cessation. Although bupropion isn’t generally considered a first line treatment for depression during pregnancy, it might be an option for women who haven’t responded to other medications. Research suggests taking bupropion during pregnancy might be associated with heart defects.

Answer 9

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Question 10

This class of medications includes nortriptyline (Pamelor). Although ______ antidepressants aren’t generally considered a first line or second line treatment, they might be an option for women who haven’t responded to other medications. The _____ antidepressant clomipramine might be associated with fetal birth defects, including heart defects. Use of these medications during the second or third trimester might also be linked with postpartum hemorrhage.

Answer 10

Tricylic Antidepressants

Question 11

the SSRI ______ (____) is generally discouraged during pregnancy. Some research suggests that ______ might be associated with a small increase in fetal heart defects

Answer 11

paroxetine (Paxil)

Question 12

What are the three subclasses of postpartum psychiatric disorders?

Answer 12

• adjustment reaction with depressed mood
• postpartum mood episodes with psychotic features
• peripartum major mood episodes (PPD)

Question 13

classified as mild depression with happier feelings intersped. (episodic tearfulness and rapid mood shifts)

Answer 13

Postpartum blues (maternal blues, baby blues)