Week 1: Common PMH disorders Flashcards
What is the perinatal period?
Pregnancy, birth and up until 6 weeks following birth of the child
What is perinatal mental illness?
period from conception to 1 year following birth of child
What is perinatal mental health?
the emotional well-being of women and their children, partner and families from conception to 1 year following birth of child
What is the impact of stress in pregnancy?
Stress in pregnancy is thought to relate to Corticotrophin Releasing Hormone (CRH) released by the Hypothalamus, which has a profound effect on mother and fetus stress response. Natural increases in the hormone are important for fetal maturation – but if levels are altered in response to stress they can program the fetal nervous system with long term consequences Delayed fetal nervous system maturation Restricted neurotransmitter development and altered stress response of the neonate Impaired mental development and increased fearful behaviour in the infant Potential reduced grey matter in children; Increased risk for emotional and cognitive impairment
What associated and aggravating factors of perinatal mental illness?
Psychosocial Factors Social Factors Family Factors Biological Factors Personal History Still Birth
What are the risk factors that predispose women to perinatal mental illness?
Family history of anxiety disorders Personal history of depression or anxiety Thyroid imbalance Low socioeconomic status Unplanned or unwanted pregnancy Childcare stress Personal characteristic
What are the poor outcomes associated with anxiety during pregnancy?
Pre-eclampsia Increased nausea and vomiting Longer sick leave during pregnancy Increased visits to obstetrician Spontaneous preterm labour and preterm delivery More difficult labour and delivery with increase of PTSD symptoms related to birth Elective caesarean section Admission of infant to neonatal care Low birth weight and low APGAR scores Breastfeeding difficulties
What types of anxiety disorders are there in the perinatal period?
Anxiety disorder in the antenatal period is one of the strongest risk factors for developing postnatal depression
What are the symptoms of anxiety disorders?
Anxiety; Apprehension expectation; Nervousness; Fatigue; excessive, intrusive and persistent worries; A pervasive feeling of apprehension or dread; Inability to tolerate uncertainty; Difficulty concentrating or focusing on things; Muscle tension; Sleep disturbance; Feeling edgy, restless or jumpy; Stomach problems, nausea, diarrhoea
How are panic disorders affected by the perinatal period?
women with a history of mild panic symptoms experience a worsening of these symptoms within the first 2 or 3 weeks after birth.
Women with this need air and space
What is tokophobia?
An irrational fear of an object or a situation leading to avoidance. Tokophobia is the extreme fear of childbirth and can lead to a woman avoiding pregnancy, terminating pregnancy of a wanted baby or demanding a C-section. It may be primary predating childbirth or secondary and relate to previous birth trauma. Studies show up to 80%, of low risk pregnant women describe common childbirth anxieties, with 5.5% to 10% reporting pathological levels of fear.
What are the symptoms of OCD?
Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images related to the baby; Compulsions, where the woman may do certain things over and over again to reduce her fears and obsessions e.g. those related to cleaning/washing and checking; Fear of being left alone with the infant; Hyper vigilance in protecting the infant; Loss of appetite; Tremendous guilt and shame. Affects 1 to 3% in pregnancy rising to 9% in post natal period.
Symptoms and risks of PTSD
Can be a consequence of a birth trauma real or perceived. Risk factors include: Domestic abuse; sexual abuse/rape; previous adverse reproductive events; history of mental health problems; migration; or type of delivery undergone. Symptoms include: Anxiety and panic attack; recurrent intrusive memories; flashbacks or nightmares; avoidance of stimuli associated with the event; depressive symptoms; fear of sexual intimacy; restricted range of affect. Prevalence: caused by childbirth ranges from 2-3%-25% in postnatal women
What are the diagnostic features of perinatal depression?
Depressed mood; Anhedonia; Insomnia or hyper insomnia; Psychomotor retardation or agitation; Loss of energy or fatigue; Worthlessness or guilt; Change in appetite; Impaired concentration; Anxiety; Irritability; Hopelessness; Feelings of isolation; Physical signs of tension; Risk to mother; Risk to infant.
What are the risks of perinatal depression?
Past history of mental illness; Antenatal anxiety; Major life events/stresses; Low social support (especially poor support from current partner and experience of intimate partner violence); History of childhood trauma and poor parenting; Substance misuse; Long standing personality vulnerabilities