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PSI Exam > PSI Diagnoses and Prevalence of PMADs > Flashcards

PSI Diagnoses and Prevalence of PMADs Flashcards

1
Q

PMAD

A

Perinatal Mood and Anxiety Disorders

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2
Q

PMAD have an ______ risk in the perinatal period

A

increased

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3
Q

what is the most under diagnosed obstetric complication in America?

A

perinatal depression

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4
Q

Who is at risk for PMAD?

A

ANYONE
-they dont discriminate
-money and socioeconomics are not protective

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5
Q

prevalence of PMADs in women?

A

1 in 5-7 women

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6
Q

prevalence of PMADS in men?

A

1 in 10 men

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7
Q

evidence based risk factors for PMADS:

A

-endocrine dysfunction
-significant mood reactions to hormonal changes
-lack of sleep
-family or personal hx of PMADS or psych disorders
-history of childhood sexual abuse

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8
Q

In the landmark study of 10,000 US mothers, how many had depression in the first year postpartum?

A

21.9%

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9
Q

when are fathers most vulnerable to post partum depression?

A

3-6 months postpartum

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10
Q

What is are the big things that distinguish normal pregnancy vs depression?

A
  1. Pregnancy: self esteem is unchanged, Depression: self esteem is low
  2. Pregnancy: no issues falling asleep, Depression: difficulty initiating sleep
  3. Pregnancy: can experience pleasure, Depression: anhedonia
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11
Q

Difference between “Baby Blues” and PP Depression?

A

Baby blues lasts 2 days to 2 weeks, depression lasts longer than 2 weeks

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12
Q

What diagnoses can the DSM specification “peripartum onset” be added on to?

A

-depression
-bipolar disorder

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13
Q

What does the DSM specifier “peripartum” refer to?

A

depression in pregnancy or within 4 weeks following birth

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14
Q

Depression DSM 5 criteria?

A

5 of SIGECAPS must be met with depressed mood

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15
Q

GAD DSM 5 criteria:

A

3 or more of the following:
-excessive anxiety and worry
-difficulty controlling worry
-agitation/irritability
-restlessness, feeling on edge
-poor concentration
-poor sleep
-increased somatic sx (muscle tension, elevate HR, etc)

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16
Q

Prevalence rate for prenatal/antenatal anxiety?

A

15.8%

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17
Q

Prevalence of postpartum anxiety?

A

8-20%

Remember: can happen for dads too, tends to decrease in prevalence for men post partum

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18
Q

Panic disorder DSM 5 criteria:

A

Four or more sx:
-intense fear reaching a peak in minutes
-shortness of breath, chest pain
-heart racing, numbness, hot flashes
-restlessness, agitation
excessive worry of fear
-fear of going crazy or losing control
-no identifiable trigger

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19
Q

Three greatest fears associated with panic disorder?

A

fear of dying, going crazy, losing control

20
Q

Perinatal OCD prevalence rate?

A

-perinatal women 1.5 to 2x greater risk for OCD than general population
-perinatal onset 32%
-can have comorbid depression

21
Q

Difference between OCD and Psychosis?

A

-OCD thoughts are ego dystonic, compulsions are performed to avoid harm, minimize triggers
-psychotic thoughts may not be noticed by individual (poor insight), less anxiety and distress over these thoughts, delusional thinking, do not question following through with acting on the disturbing thoughts

22
Q

Gold standard treatment for OCD?

A

exposure and response prevention

23
Q

How to screen for OCD?

A

Providers must ask about scary or unusual thoughts

24
Q

A patient experiences traumatic event. How long must they experience symptoms for it to be considered PTSD?

A

at least 1 month

25
Q

Prevalence of Perinatal PTSD?

A

-prenatal 3.3%
-postpartum 4%; 18.5% in high risk groups

26
Q

What is Birth Trauma?

A

event during labor and birth involving serious physical or moral injury or death

27
Q

How can you prepare for birth trauma?

A

Do a Delivery Coping Plan (trauma-informed birth planning activity)

28
Q

Who is more at risk for pregnancy related mortailty?

A

people of color, particularly black women (3.2 times higher in black women, 2.3 times higher in other POC)

29
Q

Black mothers are ___ times more likely to die from maternity related complications compared to white mothers.

A

4

30
Q

Of women screening positive for depression, how many actually have bipolar disorder?

A

22.6%

31
Q

Difference between mania and hypomania?

A

mania impairs functioning, hypomania improves funcitoning

32
Q

50 % of women with bipolar disorder are first diagnosed when?

A

postpartum

33
Q

What is the risk of relapse of bipolar 1 mood episode during pregnancy?

A

71%

34
Q

What is the risk of recurrence of bipolar 1 mood episode in women who stop mood stabilizers?

A

2x risk of recurrence, 4x times more rapidly than women on medication

35
Q

What is the risk of psychotic episode in women with bipolar 1?

A

20-30%

36
Q

What is the risk of relapse of bipolar mood episode during pregnancy?

A

45-52%

37
Q

When are women with bipolar disorder most succepitble to mood episode relapse during perinatal period?

A

70% relapse within the first 6 months post partum

38
Q

Prevalence of postpartum psychosis

A

1-2 out of every 1,000 women

39
Q

Risk factors for perinatal psychosis

A

-first baby
-discontinuation of mood stabilizer
-obstetric complications
-perinatal/neonatal loss
-previous bipolar or psychotic episodes
-family hx of bipolar or postpartum, psychosis
-sleep deprivation

40
Q

time period most vulnerable for postpartum psychosis

A

within 2 weeks postpartum

41
Q

how to reduce risk for postpartum psychosis

A

-women with Bipolar disorder should remain on mood stabilizer through pregnancy to prevent postpartum relapse
-initiate treatment immediately post partum in women with history of postpartum psychosis only
-good sleep

42
Q

risk of recurrence of psychotic episode in women with hx of PP psychosis after a subsequent pregnancy

A

29%

43
Q

percentage of women with hx of PP psychosis only who DID NOT have recurrence of psychotic symptoms outside of PP period:

A

43.5%

44
Q

in 2022, 204,000 pregnant women used drugs nationally. what is this percentage?

A

10%

45
Q

most common substances used in pregnancy?

A

alcohol, tobacco, cannabis

46
Q

presence of births associates with OUD have increased how many times?

A

4 times, from 1.5 in every 1000 to 6.5 in every 1000 deliveries

47
Q

substance use disorder is related to how many pregnancy-related maternal deaths?

A

25%

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