Postnatal: Postnatal depression

Question 1

Define postnatal depression.

Answer 1

development of a depressive illness following childbirth
DSM <4w
In practice <1y of giving birth

Question 2

Give 3 risk factors for postnatal depression.

Answer 2

Previous MH issues
MH issues during pregnancy
Poor social support

Question 3

Summarise the epidemiology of postnatal depression.

Answer 3

10-15% mothers

Usually within 3m of birth.

Question 4

What are the signs and symptoms of postnatal depression?

Answer 4

May develop insiduously over weeks or exacerbation of baby blues.

Low mood

Anergia

Anhedonia

Sleep/ appetite/ concentration/ libido changes.

Question 5

What thoughts/ feelings may be experienced by a woman with postnatal depression?

Answer 5

Guilt
Worthlessness
Self loathing
Anger
Thoughts of harming self/ baby

Question 6

What are 2 social signs of postnatal depression?

Answer 6

Withdrawal from social contacts
Difficulty bonding with baby

Question 7

What is the management for postnatal depression?

Answer 7

Assess risk to mother + child. Involve postnatal community MH team

Mild: self help

Moderate: Sertraline +/- CBT +/- admission to mum + baby unit.

Severe: Sertraline + Admission to mum + baby unit + CBT

Question 8

What is the prognosis for postnatal depression?

Answer 8

Most recover within 1 month

Question 9

What screening tool is used for postpartum depression?

Answer 9

Edinburgh Postnatal Depression Scale
>13 indicates depressive illness