Psychiatry in non-psychiatric settings Flashcards
Referral to a specialist liaison psychiatric service indications
Any mental health problem that is moderate to severe and/or impairing physical healthcare
Behaviour which poses a significant, imminent risk to the patient or others
Post-natal depression
Significant mood disorder that can develop at any time up to one year after the birth of a baby
Post-natal depression risk factors
Low socioeconomic status
History of mental health disorders
Lack of social support
Post-natal depression aetiology
Biological factors - hormonal fluctuations post-delivery, alterations in melatonin & cortisol
Psychological factors - history of mood/anxiety, previous episodes of postpartum depression
Social factors - lack of social support, relationship issues, life stressors, low socioeconomic status
Post-natal depression clinical features
Persistent lowering of mood and reduced enjoyment/interest in activities
Lowering of energy levels
Biological symptoms of depression
Concerns related to bonding with the baby, caring for the baby & in extreme circumstances, thoughts about harming oneself/the baby
Post-natal depression mx
First line treatments involve self-help strategies and psychological therapies → CBT
Pharmacological treatments (antidepressants) are considered in cases of high severity/distinct risks
Severe cases → admission to a mother and baby inpatient mental health unit might also be necessary
Puerperal psychosis clinical features
Paranoia
Delusions
- Capgras delusions - misidentification syndrome characterised by the belief by the patient that the close person is replaced by an imposter who looks physically the same
Hallucinations
Manic episodes
Depressive episodes
Confusion
Puerperal psychosis mx
Referral to a specialist mother and baby inpatient mental health unit
Antipsychotic medications - olanzapine and quetiapine are safe to take while breastfeeding
Mood stabilisers in some instances
