Post-Partum Disorder

Question 1

How is workup done for Post Partum depression

Answer 1

Edinburgh Postnatal Depression Scale

Question 2

Post-Partum Depression.
(1) Time period varies but usually described as depression occurring within the first __ months after delivery.
(2) Diagnostic criteria are the same as those for major depressive disorder, must have at least ___ symptoms for at least __ weeks

Answer 2

1) 12 months
2) 5 symptoms, 2 weeks

Question 3

Post-Partum Depression differential diagnosis
What issue?
-Similar symptoms but does not meet the minimum number of symptoms; milder and self-limited; typically develop within 2-3 days of delivery and resolve within 2 weeks.

Answer 3

Post-partum “blues”.

Question 4

Treatment Post partum depression

Answer 4

(1) For mild to moderate, recommend psychotherapy such as CBT as initial treatment; especially useful for breastfeeding moms as they won’t expose children to antidepressants.
2) If CBT is unsuccessful or depression is more severe, antidepressants (SSRIs, Bupropion (Wellbutrin), Mirtazapine (Remeron)) are useful.
(3) SSRIs: Paroxetine (Paxil) or Sertraline (Zoloft) appear to have lowest adverse effects on infants.

Question 5

Prognosis Post partum depression
(1) Comorbid mental illness __________ is common.
(2) Episodes of postpartum depression last at least one year in 30 - 50% of patients. Those who recover are at risk for ________.
(3) Suicide attempts are rare, suicide ideation occurs in about 3% of postpartum women and
infanticide is rare but more likely in women who are psychotic.
(4) Adverse effects include interference with breastfeeding, care of the infant or other children, and the woman’s relationship with partner.
(5) Has been associated with abnormal development, cognitive impairment, and psychopathology in the ________.

Answer 5

1) anxiety disorder
2) recurrences
5) children