Screening for PMADs

Question 1

PSI recommendations for PMAD screening

Answer 1

-first prenatal visit
-once in second trimester
-once in third trimester
-6 weeks postpartum visit
-6 and 12 months postpartum
-3, 9, and 12 month pediatric visits

Question 2

most well researched and validated perinatal screening measures:

Answer 2

-Edinburgh Postnatal Depression Scale
-PHQ 9

Question 3

Brief screening tools for depression:

Answer 3

-PHQ 2 (highest sensitivity)
-EPDS 2 (accurate in identifying depression in adolescent mothers)
-NEITHER ASSESS FOR SUICIDALITY

Question 4

What to use when screening for bipolar disorder?

Answer 4

MDQ (Mood Disorder Questionaire)

Question 5

How to screen for Trauma?

Answer 5

-ACES
-Urban ACES
-Life events checklist
-PCL-C
-IES-R

Question 6

What did Urban ACES study find?

Answer 6

almost 40% of Philadelphians experienced 4 or more of the expanded, community level ACES (asks about poverty, racism, etc)

Question 7

What statement is concerning for a mother contemplating suicide?

Answer 7

that the baby will be better off without her

Question 8

What is a “positive” screen for suicide?

Answer 8

-EPDS # 10: “the thought of harming myself has occurred to me”
-PHQ 9 #9: “thoughts that you would be better off dead”

Question 9

Next steps after someone screens positive for suicide (EPDS #10 or PHQ #9)?

Answer 9

-proceed with same day comprehensive suicide risk assessment (can use Columbia)
-document interactions, recommendations provided, and safety plan

Question 10

When is the most common peak of risk for PMADs in the perinatal period?

Answer 10

3 months after birth