Postpartum mental health problems Flashcards
Postpartum mental health problems
The Edinburgh Postnatal Depression Scale may be used to screen for depression:
10-item questionnaire, with a maximum score of 30
indicates how the mother has felt over the previous week
score > 13 indicates a ‘depressive illness of varying severity’
sensitivity and specificity > 90%
includes a question about self-harm
‘Baby-blues’
-Seen in around 60-70% of women
-Typically seen 3-7 days following birth and is more common in primips
-Mothers are characteristically TIA-anxious, tearful and irritable
Mgt:
Reassurance and support, the health visitor has a key role
Postnatal depression
-Affects around 10% of women
-Most cases start within a month and typically peaks at 3 months
-Features are similar to depression seen in other circumstances
-Mgt:
As with the baby blues reassurance and support are important
Cognitive behavioural therapy may be beneficial. Certain SSRIs such as sertraline and paroxetine* may be used if symptoms are severe** - whilst they are secreted in breast milk it is not thought to be harmful to the infan
Puerperal psychosis
-Affects approximately 0.2% of women
-Onset usually within the first 2-3 weeks following birth
-Features include
–severe swings in mood (similar to bipolar disorder) and
–disordered perception (e.g. auditory hallucinations)
Mgt:
Admission to hospital is usually required, ideally in a Mother & Baby Unit
There is around a 25-50% risk of recurrence following future pregnancies
