Perinatal psychiatry Flashcards
What 3 main conditions should you consider when evaluting a woman’s pyschological symtoms who has just given birth?
- Postnatal blues
- Postnatal depression
- Puerperal psychosis
Symptoms of post natal blues?
Typical sx:
- emotional lability
- tearfulness
- mild anxiety
- irritability
Sx generally mild and not pervasive
How common is postnatal blues?
When does it occur?
How long does it last?
- Common occurrence in postpartum period, 50-80%
- Most frequently present about Day 5 but usually present between Day 3 to 10
- The Blues generally last 48 hours and no specific treatment is required
What causes postnatal blues?
Attributed to hormonal changes in combination with physical and emotional exhaustion
What are risk factors for postnatal depression?
- If woman has suffered previous severe depressive illness or PND illness, risk of developing a further illness following this delivery is around 50%
- Depression history
- Psychiatric disorders
- Traumatic birth/pregnancy
When does postnatal depression occur?
- Peak onset b/w 2-4w postpartum
- secondary peak around 3m postpartum
How long does it take to recover from postnatal depression?
- With prompt and appropriate treatment 2/3 of illnesses will resolve within 2-3m
- Without treatment, it can take 6m or longer to recover
How is puerperal psychosis characterised?
Sudden onset of:
- behavioural disturbances
- hallucinations
- delusions
- fear
- perplexity
What does puerperal psychosis occur?
- 50% present by day 7
- 75% present by day 16
- 95% present by day 90
What is the risk of post-partum pychosis if the patient has Bipolar Disorder or previous postpartum psychosis
50%
(99% of postpartum psychoses are either bipolar or schizoaffective disorder)