Postnatal Psych

Question 1

What are maternal blues?

Answer 1

AKA Baby blues
Affects 2/3 women
3-5days postpartum
Lasts no longer than 10days

Question 2

What are the signs & symptoms of baby blues?

Answer 2

Low mood
Tearful
Recover spontaneously

Question 3

When does postnatal depression occur?

Answer 3

3m postpartum
Usually lasts around 6m
10% of women

Question 4

What are the signs & symptoms of postnatal depression?

Answer 4

Same as depression
Insomnia, tiredness, low libido may be normal postpartum
Other: Obsessional thoughts, intrusive thoughts about harming the baby, inquisitive thoughts about baby/maternal health, thoughts about competence

Question 5

What is Couvade syndrome?

Answer 5

Occurs in males around time of birth

Experience symptoms similar to those in pregnancy

Question 6

What is premenstrual syndrome?

Answer 6

Emotional & physical symptoms during 2nd half of menstrual cycle
Increase in intensity until menstruation

Question 7

What are the symptoms of PMS?

Answer 7

Mood: irritable, low
Tiredness
Tension
Emotionally labile

Question 8

How is PMS managed?

Answer 8

Supportive: Analgesia
Identify & avoid stressors
Antidepressants (SSRI): Alleviating psych symptoms
OCP: Alleviating physical symptoms

Question 9

When is puerperal psychosis seen?

Answer 9

First 6weeks postpartum

Affects 1 in 500

Question 10

What are the signs & symptoms of puerperal psychosis?

Answer 10

Rapid onset
Insomnia
Irritable
Acute confusion'
Psychosis

Question 11

How is puerperal psychosis managed?

Answer 11

Emergency
Admit to specialist unit
Keep mother & baby together
ECT sometimes required

Question 12

How is postnatal depression managed?

Answer 12

NOT breastfeeding: Treat as depression (SSRI)
IS breastfeeding:
mild-mod: Self-help, brief psychological treatment
w/hx of psych condition consider antidepressants
Severe: IPT/CBT, antidepressant

Treatment required: Therapy commenced within 1month

Question 13

What psych meds should not be used in breastfeeding?

Answer 13

AVOID:
Antidepressants: Fluoxetine, Venlafaxine
Antipsychotic: Olanzapine, Quetiapine, Clozapine, Lithium

CAUTION:
Antidepressants: Citalopram, Sertraline, Mirtazapine
Antipsychotic: Risperidone

Question 14

What is the SSRI of choice for breastfeeding women?

Answer 14

Paroxetine

Question 15

What are the criteria for diagnosis PMS?

Answer 15

1) Somatic & affective symptoms during 5days before menses in 3cycles
2) Relief of symptoms within 4days if onset of menses
3. Affect on functioning