Perinatal psychiatry Flashcards
What are baby blues? How common are they and when are they most often seen?
A transient, self-limiting condition, seen in 75% of new mothers.
Most often 3-5 days after delivery. Mums are tearful, anxious and irritable
What is the risk of postnatal depression? Give 4 risk factors.
10% w/o psychiatric Hx, 25% w/depression hx, 50% w/previous postnatal depression. RF: mental health problems (as above), unplanned pregnancy, lack of support, marital/relationship problems, social problems
How long do they normally last and how are they treated?
Normally last 1-2 days but can be 2 weeks.
When does most postnatal depression resolve? why is this not necessarily good news?
After 6 months – but this is a very long time for mum and baby!
Give a screening test.
Edinburgh postnatal depression scale
Give 2 treatments. What should not be used?
CBT, antidepressants. Antidepressants are as effective short term as CBT. TCAs and SSRIs are virtually undetectable in breastmilk but fluoxetine is not!
What may be needed in severe cases?
Admission +- ECT.
What does postpartum psychosis present with?
Psychotic episodes with prominent depression and/or mania. Occurs with rapidly fluctuating symptoms, labile mood and insomnia
What should suspicion of it lead to?
Urgent referral
When is peak onset
2 WEEKS
Give 3 risk factors and recurrence rate
social isolation
preexisting MH
lack of support
30% recurrence
How do you prevent recurrence?
specialist referral
close monitoring
What medications and therapies are used to treat it?
Combination of meds to target 1) affective symptoms: Mood stabiliser/antidepressant/ECT. 2) psychotic symptoms: SGA/TGA +- benzodiazepine. Therapies: reassurance, emotional support. refer to community mental health team on discharge
