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Behavioral Health > Postpartum Depression > Flashcards

Postpartum Depression Flashcards

1
Q

Postpartum Mood Disorders

A

Postpartum blues
Postpartum depression
Postpartum psychosis
Postpartum anxiety disorder

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2
Q

% of new mothers with postpartum blues

A

50-85%

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3
Q

Time Course of Postpartum Blues

A

Begins 48 hours after delivery
Peaks 3-5 days
Lasts around 2 weeks

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4
Q

Etiology of Postpartum Blues

A

Coping with a new child

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5
Q

Risk Factors for Postpartum Blues

A

Hx of depression
Depressive symptoms during pregnancy
Family Hx of depression
Premenstrual or OCP associated mood changes
Stress around child care
Psychosocial impairment in the areas of work, relationships, & leisure activities

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6
Q

Symptoms of Postpartum Blues

A 
Mood lability
Tearfulness
Sadness or elation
Anxiety
Irritability
Insomnia
Decreased concentration
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7
Q

Treatment for Postpartum Blues

A

Supportive with reassurance to the woman & family
Allow woman enough rest
Someone to help take care of the infant & night
Careful monitoring for the development of postpartum depression

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8
Q

Onset for Postpartum Psychosis

A

Within 2 weeks of delivery

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9
Q

Women with what are more likely to commit suicide or infanticide

A

Postpartum Psychosis

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10
Q

Pathogenesis of Postpartum Psychosis

A

Hormonal factors
Genetic factors
Currently thought of as a manifestation of bipolar disorder

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11
Q

Risk Factors for Postpartum Psychosis

A 
First pregnancy
Hx of bipolar disorder
Hx of puerperal psychosis
Family Hx of puerperal psychosis
Recent discontinuation of lithium or other mood stabilizers
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12
Q

Symptoms of Postpartum Psychosis

A 
Delusions
Hallucinations
Thought disorganization
Severe insomnia
Suicidal ideation
Homicidal ideation
Aggression
Agitation
Impulsivity
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13
Q

Treatment of Postpartum Psychosis

A 
Acute hospitalization
Antipsychotics
Therapy
ECT if pharmacotherapy unsuccessful
MEDICAL EMERGENCY
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14
Q

Postpartum Anxiety Disorders

A

OCD
Panic disorder
GAD
PTSD

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15
Q

Define Obsession

A

Idea or thought that continually preoccupies or intrudes on a person’s mind

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16
Q

Define Compulsions

A

Irresistible urge to behave in a certain way, especially against one’s conscious wishes

17
Q

Risk Factors for Postpartum Depression

A

Marital conflict
Stressful life events, lack of social support for pregnancy
Lack of emotional/financial support
Living without a partner
Unplanned pregnancy, previous miscarriage
Having contemplated terminating the pregnancy
Poor relationship with one’s own mother
High # of visit’s to prenatal clinic
Congenitally malformed child
Personal Hx of bipolar disorder

18
Q

Symptoms for Postpartum Depression

A

Irritability & anger
Significant anxiety with panic attacks
Feelings of inadequacy & failing as a mother
Feelings of guilt
Feelings of hopelessness or despair
Feeling of being overwhelmed or unable to care for the baby
Not bonding to the baby
Typical: insomnia, weight changes, decreased libido, decreased energy levels

19
Q

Postpartum Depression Screening

A

Edinburgh postnatal depression scale (EPDS)
Postpartum depression screening scale (PDSS)
BECK depression inventory
Personal interview

20
Q

What medical causes need to be ruled out when considering postpartum depression?

A

Anemia
Diabetes
Thyroid disorders

21
Q

6 Stages of Postpartum Depression

A 
Denial
Anger
Bargaining
Depression
Acceptance
PTSD
22
Q

Symptoms of Men’s Postpartum Depression

A

Increased anger & conflict with others
Increased use of ETOH or other drugs
Frustration or irritability
Violent behavior
losing weight without trying
Isolation from family & friends
Being easily stressed
Impulsiveness & taking risks
Feeling discouraged
Increases in complaints about physical problems
Ongoing physical symptoms
Problems with concentration & motivation
Loss of interest in work, hobbies & sex
Working constantly
Frustration or irritability
Misuse of prescription medication
Increased concerns about productivity & functioning at school or work
Fatigue
Experiencing conflict between what you think & how you are
Thoughts of suicide

23
Q

Treatment Options for Postpartum Depression

A

Psychotherapy: interpersonal, CBT, group therapy

24
Q

Considerations with Breastfeeding in Postpartum Depression

A

Risk vs. benefits

Evaluation of infant

25
Q

Medications for Postpartum Depression Treatment

A 
TCAs
SSRIs
SNRIs
Other antidepressants
Benzodiazepine
Sedative hyponotics
26
Q

TCAs for Treatment of Postpartum Depression

A

Amitriptyline (Elavil)
Nortriptyline (Pamelor)
Doxepin (Silenor)

27
Q

SSRIs for Treatment of Postpartum Depression

A

Sertraline (Zoloft)
Paroxetine (Paxil)
Citalopram (Celexa)
Escitalopram (Lexapro)

28
Q

SNRIs for Treatment of Postpartum Depression

A

Duloxetine (Cybalta)

Venlafaxine (Effexor XR)

29
Q

Other Antidepressant for Treatment of Postpartum Depression

A

Bupropion SR/XL
Budeprion SR/XL
Mirtazipine (Remeron)
Trazodone (generic only)

30
Q

Benzodiazepines for Treatment of Postpartum Depression

A 
Oxazepam (Serax)
Alprazolam (Xanax)
Temazepam (Restoril)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Diazepam (Valium)
31
Q

Sedative Hypnotics for Treatment of Postpartum Depression

A

Zaleplon (Sonata)
Zolpidem (Ambien)
Escopiclone (Lunesta)

32
Q

Optional Treatment for Postpartum Depression

A

ECT

33
Q

Postpartum Blues

A

Incidence: 50-85%
Duration: 2-3 days, resolves within 10 days
Symptoms: tearfulness, fatigue, depressed affect, irritability
Treatment: reassurance, watchful waiting

34
Q

Postpartum Depression

A

Incidence: 10-15%
Duration: 2 weeks to 12 months
Symptoms: depressed affect, anxiety, symptoms worse at night, poor concentration, decreased libido
Treatment: antidepressants, psychotherapy

35
Q

Postpartum Psychosis

A

Incidence: 0.1-0.2%
Duration: typically days to 6 weeks
Symptoms: delusions, confusion, sleep disturbances, unusual behavior, emotional liability
Treatment: antipsychotics, antidepressants, inpatient hospitalization

Behavioral Health (25 decks)

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