Perinatal Psychiatry Flashcards
Prevalence of women who suffer depression in pregnancy or postnatally
13-20%
Risks of untreated MI in pregnancy (7)
Suicidal behaviour Poor self-care Inadequate nutrition Poor antenatal clinic attendence direct effects on foetus Impact on relationships Impact on future attachment
Four common postpartum disorders
Postpartum blues (“baby blues”) - early
Postpartum depression - can happen any time
Postpartum psychosis - early
Adjustment disorder with anxiety and depression
How often does postpartum psychosis occur?
0.1-0.2% of births
When does postpartum psychosis occur?
1-6 weeks after delivery
Which mental disorders increase the incidence of postpartum psychosis?
Bipolar disorder, schizoaffective disorder or schizophrenia
Course and nature of postpartum psychosis
Rapid development of symptoms including delusions, hallucinations, marked sleep disturbance, obsessive thoughts about the baby, rapid mood swings, extreme anxiety, agitation, and suicidal/homicidal thoughts
How often does postnatal depression occur?
10-15% of mothers
How long does postnatal depression last for?
Up to a year
How many women experience ‘baby blues’
70-80%
How do you screen for PND?
Edinburgh Postnatal Depression Scale (EPDS)
Assessment of PND (4)
Rule out medical causes
Take a medical and family history
Rule out substance use/abuse
Do a physical examination (esp. BP)
Non-pharmacological treatment for PND (5)
Counselling/psychotherapy Support groups / antenatal groups Self-help Exercise Harnessing support of family and friends
Pharmacological treatment and dose for PND (4)
- SSRIs - sertraline 50-150mg or citalopram 20-60mg
- Tricyclics - amitriptyline
- SNRIs - venlafaxine 75-300mg
- ECT if very severe and treatment resistant
