Obs Psych Flashcards
WHat scale can be used in post natal depression and what does it involve?
Edinburgh Postnatal Depression Scale
10-item questionnaire, with a maximum score of 30
indicates how the mother has felt over the previous week
score > 13 indicates a ‘depressive illness of varying severity’
sensitivity and specificity > 90%
includes a question about self-harm
How common is baby blues and when does it present?
60-70% of women
3-7 days
Who gets baby blues?
Primips more comon
What are baby blues features?
Anxious, tearful, irritable
How are baby blues managed?
Reassurance and support
Health visitor has a key role
How common is postnatal depression and when does it present?
10%
Most start within a month, peaks at 3 months
WHat are the features of postnatal depression?
Similar to depresion of any kind
- low mood
- anhedonia
- fatigue
How common is puerperal psychosis and when does it present?
0.2%
ONset usually in the first 2-3 weeks
What are the features of Puerperal psychosis
severe swings in mood (similar to bipolar disorder) and disordered perception (e.g. auditory hallucinations)
How is postnatal depression managed?
reassurance and support are important
Cognitive behavioural therapy may be beneficial. Certain SSRIs such as sertraline and paroxetine* may be used if symptoms are severe** - whilst they are secreted in breast milk it is not thought to be harmful to the infant
How is puerperal psychosis managed?
Admission usually required- mother and baby unit
Risk of puerperal psychosis in future pregnancies?
around 20%
Which SSRI should not be used postnatally?
Fluoxetine-long half life
