Perinatal Psychiatry

Question 1

Women with which previous/current medical conditions should be screened?

Answer 1

Schizophrenia/psychosis
BPD
Severe depression
Postpartum psychosis

Question 2

Other reasons (apart from current/prev psych medical conditions) a woman would be screened?

Answer 2

If on mood stabilisers

If has FHX of any of the psych disorders

Question 3

Prevalence post-natal depression

Answer 3

15-30%

Question 4

Prevalence post-natal depressive ep

Answer 4

10%

Question 5

Prevalence post natal mod/severe depressive ep

Answer 5

3-5%

Question 6

Prevalence postnatal psychosis?

Answer 6

0.2%

Question 7

When do the ‘pinks’ happen?

Answer 7

First 48hrs postpartum

Question 8

Sx of the ‘pinks’

Answer 8

Excitement + euphoria

Overtalkative + overactive + insomnia

Question 9

What % people get the ‘blues’?

Answer 9

50-80%

Question 10

When do the blues present?

Answer 10

Around day 5

Question 11

Why do the blues occur?

Answer 11

Hormone changes

Physical + emotional exhaustion

Question 12

Sx of the ‘blues’?

Answer 12

Emotional liability, tearfulness, mild anxiety, irritability

Question 13

How long do the blues tend to last for?

Answer 13

48hrs

Question 14

Sx of postpartum depression

Answer 14

Guilt about concerns about parental ability
Doesn’t want to interact with baby
Suicidal

Question 15

Peak onset postpartum depression

Answer 15

c 2-4 weeks postpartum

Question 16

When is the 2’ peak postpartum depression

Answer 16

3 months

Question 17

What % postpartum depression will resolve within 2-3 months with Tx?

Answer 17

2/3

Question 18

RF’s postpartum depression (2)

Answer 18

Previous depressive illness

Previous postnatal depression

Question 19

Sx pueperal psychosis

Answer 19

Sudden onset behavioural disturbances, hallucinations, delusions, fear, perplexity

Question 20

At day 7, what % puerperal psychosis have presented?

Answer 20

50%

Question 21

By which day has 95% of puerperal presented?

Answer 21

90

Question 22

What % women w/ puerperal psychosis have either Bipolar or schizoaffective disorder?

Answer 22

99%

Question 23

What is the % risk of getting puerperal psychosis if you have Bipolar?

Answer 23

50%

Question 24

What is the % risk of getting puerperal psychosis if you previously had it?

Answer 24

50%

Question 25

What is included in the birth plan?

Answer 25

Monitoring MH immediately following delivery
Use prophylactic meds where appropriate
Consider child protection
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