wamss notes perinatal mental health

Question 1

postpartum depression

Answer 1

Low mood & depressive symptoms in the postpartum period 4weeks post birth

Question 2

epidemiology of post party depression

Answer 2

3-6%

Can affect males as well as females
50% begin prior to delivery

Question 3

criteria of post party depression

Answer 3

Fits the criteria for MDD with onset in the peripartum period: 4 weeks post birth

Question 4

Sx of post party depression

Answer 4

Sadness, worry or empty mood
Labile mood
Frustration, irritability, anger
Guilt, shame, worthlessness, hopelessness
Low energy & libido
Fatigue
Changes in sleep or appetite
Decreased concentration
Fear of not taking care of baby
Infanticidal thoughts

Question 5

screening for post party depression

Answer 5

Edinburgh Postnatal Depression Scale

Question 6

causes of post party depression

Answer 6

Rapid alteration in hormones – withdrawal of oestrogen, progesterone & endorphins…
Physical mental & emotional exhaustion + sleep deprivation

Question 7

risk factors of post party depression

Answer 7

Prenatal anxiety or depression
Personal or family history of depression or postnatal depression
Birth-related psychological or physical trauma
Poor marital relationship or single
Low socioeconomic status
Unwanted / unplanned pregnancy

Question 8

treatment for post party depression

Answer 8

Social & psychological therapy & support
Group therapy, home visits
SSRI sometimes utilised

Question 9

baby blues

Answer 9

Transient condition in which shortly after childbirth mother experiences variety of Sx similar to depression but resolves within 2 weeks

Question 10

epidemiology of baby blues

Answer 10

70%

Question 11

symptoms of baby blues

Answer 11

Weepiness & bursting into tears
Mood swings
Anxiousness & hypersensitivity to criticism
Low spirits & irritability
Poor concentration & indecisiveness
Feeling ‘unbonded’ with baby
Restless insomnia
Anxiety & Depressive Sx

Question 12

causes of baby blues

Answer 12

Rapid alteration in hormones – withdrawal of oestrogen, progesterone & endorphins

Physical mental & emotional exhaustion + sleep deprivation
Increases risk for episode of postpartum major depression

Question 13

baby pinks

Answer 13

post partum euphoria
Mild to severe form of mania in the postpartum period
Can progress to postpartum psychosis

Question 14

post partum euphoria may progress to

Answer 14

post partum psyhcosis

Question 15

baby blues increase risk of

Answer 15

post partum depression

Question 16

post partum psychosis

Answer 16

Rare psychiatric emergency in which psychotic & other mood symptoms beginning suddenly in the first two weeks after childbirth.

Question 17

epidemiology of post party psychosis

Answer 17

1:1000 births

50% have prior mental illness

Question 18

symptoms of post party psychosis

Answer 18

• Mania- high mood & racing thoughts
• Depression
• Severe confusion
• Loss of inhibition
• Paranoia
• Hallucinations
• Delusions

Question 19

treatment for post party psychosis

Answer 19

Hospitalisation
Antipsychotics or mood stabilisers
Assess for infanticide

Question 20

prognosis for post party psychosis

Answer 20

Most severe Sx 2-12 weeks
Can take 6months – year to recover
50-70% reoccurrence

Question 21

premenstrual dysphoric disorder

Answer 21

Symptoms of mood lability, irritability & anxiety that occur repeatedly around the onset of menses and then decrease or dissipate

Question 22

criteria for premenstraul dysphoric disorder

Answer 22

In the majority of menstrual cycles at least 5 symptoms are present in the week before the
onset of menses & start to improve a few days after the onset of menses & become minimal
or absent in the week post-menses
- Marked lability (mood swings)
- Marked irritability or anger
- Marked depressed mood
- Marked anxiety or tension
- Decreased interest in usual activities
- Difficulty concentrating
- Appetite change
- Sleep disturbances
- Sense of being overwhelmed or out of control
Physical Sx such as breast tenderness, joint pain, bloating, weight gain