Perinatal Psychiatry Flashcards
Women with which previous/current medical conditions should be screened?
Schizophrenia/psychosis
BPD
Severe depression
Postpartum psychosis
Other reasons (apart from current/prev psych medical conditions) a woman would be screened?
If on mood stabilisers
If has FHX of any of the psych disorders
Prevalence post-natal depression
15-30%
Prevalence post-natal depressive ep
10%
Prevalence post natal mod/severe depressive ep
3-5%
Prevalence postnatal psychosis?
0.2%
When do the ‘pinks’ happen?
First 48hrs postpartum
Sx of the ‘pinks’
Excitement + euphoria
Overtalkative + overactive + insomnia
What % people get the ‘blues’?
50-80%
When do the blues present?
Around day 5
Why do the blues occur?
Hormone changes
Physical + emotional exhaustion
Sx of the ‘blues’?
Emotional liability, tearfulness, mild anxiety, irritability
How long do the blues tend to last for?
48hrs
Sx of postpartum depression
Guilt about concerns about parental ability
Doesn’t want to interact with baby
Suicidal
Peak onset postpartum depression
c 2-4 weeks postpartum
When is the 2’ peak postpartum depression
3 months
What % postpartum depression will resolve within 2-3 months with Tx?
2/3
RF’s postpartum depression (2)
Previous depressive illness
Previous postnatal depression
Sx pueperal psychosis
Sudden onset behavioural disturbances, hallucinations, delusions, fear, perplexity
At day 7, what % puerperal psychosis have presented?
50%
By which day has 95% of puerperal presented?
90
What % women w/ puerperal psychosis have either Bipolar or schizoaffective disorder?
99%
What is the % risk of getting puerperal psychosis if you have Bipolar?
50%
What is the % risk of getting puerperal psychosis if you previously had it?
50%
What is included in the birth plan?
Monitoring MH immediately following delivery
Use prophylactic meds where appropriate
Consider child protection
ER contact details
