Perinatal psychiatry

Question 1

When do the pinks and blues occur? symptoms? duration?

Answer 1

Day 5 postnatally in 50-80% of mothers, anxious, tearful, exhausted lasting 48 hours

Question 2

When does milk-moderate post natal depression usually reveal itself? first line and second line treatment?

Answer 2

3 months to 1 year after birth. first line counselling and support, second line antidepressants

Question 3

When does severe depression usually reveal itself?

Answer 3

earlier than mild-moderate usually in first 2 weeks

Question 4

What is reoccurence risk of severe post natal depression?

Answer 4

33-50%

Question 5

Rate of puerperal psychosis?

Answer 5

2/1000 deliveries

Question 6

What is the onset like of puerperal psychosis?

Answer 6

50% in 7 days, 75% in 16 days, 95% in 90 days

Question 7

Symptoms of puerperal psychosis?

Answer 7

delusions, hallucinations, agitation, confusion, fearful

Question 8

Risk of puerperal psychosis reoccurrence in future pregnancies?

Answer 8

50%

Question 9

Which antidepressant should not be taken in the first trimester?

Answer 9

Sodium valproate

Question 10

How do you manage a postpartum patient with a known psychiatric disorder?

Answer 10

restart medication, consider breastfeeding depedning on drug half life, baby prematuriy and comorbidity, avoid feed at peak plasma level and divided doses on first few weeks

Question 11

Which antidepressants can not be given when the woman is breastfeeding?

Answer 11

Lithium, trazadone