Perinatal Psychiatry

Question 1

1. What are the red flags of perinatal psychiatry?

Answer 1

1. Significant change in mental state. Violent self-harm. Estrangement from the baby.

Question 2

1. What is Baby Blues?
2. How long does it usually last?
3. How does it present?

Answer 2

1. Brief period of emotional instability that occurs in 50% women following birth.
2. 3-10 days
3. Tearful, irritable, anxious, poor sleep, confusion

Question 3

1. Define Puerperal Psychosis
2. How does it present?
3. Identify some of the risk factors?

Answer 3

1. Psychosis that is triggered by childbirth and usually arises in the first two weeks after birth.
   It is an emergency and must be treated in a mother and baby unit.
2. Early symptoms are sleep disturbance and confusion, irrational ideas
3. Bipolar disorder, previous puerperal psychosis (50%), 1st degree relative with history of bipolar disorder
   Mania, delusions, hallucinations, confusion

Question 4

1. Define Postnatal Depression
2. What are the risks of this in comparison to depression generally?
3. What is the first line treatment?

Answer 4

1. Depression with an onset 2-6 weeks following postnatally.
2. Effects bonding to new-born, could lead to attachment disorders, effects child development, increased risk of violent suicide for women, effects marriages.
3. SSRIs: Sertraline or Fluoxetine