Perinatal

Question 1

What are the criteria, from antenatal screening, for perinatal psychiatric referral (7)

Answer 1

• Schizophrenia or psychosis
• Bipolar disorder
• Postpartum psychosis
• Severe depression
• All women on mood stabilisers
• FH bipolar/schizoaffective disorder AND PMH any psychiatric disorder
• If previously been seen by psychiatrist

Question 2

What are ‘the pinks’ in perinatal psychiatry?

Answer 2

Normal phenomena of first 48hrs
Excitement/euphoria
Overtalkative/overactive + insomnia

Question 3

What are ‘the blues’ in perinatal psychiatry?

What incidence/when

Answer 3

Affects 50-80% in postpartum period
Occurs for 48hrs b/wn day3-10

Mild Sx: tearfulness, emotional lability, mild anxiety + irritability

Question 4

When are the peak onsets of depressive episodes postnatally?
What are the psychological effects/ features? (2)
What is the prognosis like?

Answer 4

2-4wks postpartum + 2nd episode 3m postpartum
Guilt + inadequate parental ability

2/3rds resolve within 2-3m

Question 5

What is the risk of recurrence after PND?

Answer 5

After previous severe depressive episode / PND

→ risk recurrence after delivery is 50%

Question 6

What is the risk of postpartum psychosis in the general population?
Which pre-existing psychiatric illnesses have increased risk? (+ what is their risk)

Answer 6

Gen pop 0.2% risk

Bipolar/schizoaffective disorder → 50% risk
+ if PMH postpartum psychosis → 50% risk