Perinatal Psychiatry

Question 1

Which screening tool is used to distinguish between baby blues and perinatal psychosis

Answer 1

Edinburgh post natal depression scale; 10item questionnaire (max score 30), >13 indicates depressive illness.

Question 2

What is the baby blues?

Answer 2

Normal experience 3-7 days after giving birth (more common in primips). Feel irritable, weepy, muddled, labile mood. Happens in 50-70% mothers.
Rx- reassurance + health visitor

Question 3

What’s postnatal depression?

Answer 3

1/10 mothers suffer in the year after the birth. (Peaks at 3months)
Management: caution with breastfeeding, in severe cases ssris can be used paxoxietine and sertraline (avoid fluoxetine) or can use Low dose amitrypaline. Mother and baby mental health units can be considered. Early inverventions!

Question 4

Puerperal psychosis presentation?

Answer 4

0.2% women, Usually within the first 2-3 weeks, sudden onset, symptoms: perplexity, insomnia, restlessness. Mood swings and disordered perceptions.

Rx- admit to mother and baby unit
20% recurrence in future pregnancies

Question 5

What are the patterns of perinatal psychosis?

Answer 5

Schizophreniform
Affective
Delirium

Question 6

When can ETC be considered in postnatal depresssion?

Answer 6

Severely sucicidal

Has stopped eating/drinking

Question 7

Can you breast feed while taking an SSRI?

Answer 7

Yes, monitor levels.
Do not use fluoxetine

Tca and SSRI are rarely detected in breast milk.