Perinatal Psychiatry

Question 1

What would necessitate an urgent referral to a specialist mental health team? (3)

Answer 1

• Recent significant change in mental state or emergence of new symptoms.
• New thoughts of violent self-harm.
• New and persistent expressions of incompetency as a mother or estrangement from their baby.

Question 2

When should admission of a mother to a mother and baby unit be considered? (5)

Answer 2

• Rapid changing mental state.
• Suicidal ideation.
• Significant estrangement from their child.
• Pervasive guilt/hopelessness.
• Evidence of psychosis.

Question 3

How long does baby blues typically last for?

Answer 3

3-10 days; generally self-limiting.

Question 4

Which SSRIs have the lowest risk during the 3rd trimester?

Answer 4

Sertaline/fluoxetine

Question 5

Which antipsychotic should be avoided at all times due to the risk of agranulocytosis?

Answer 5

Clozapine

Question 6

Toxicity from which drug can mimic PET?

Answer 6

Lithium

Question 7

What is the difference in risk of a neural tube defect when a mother is taking sodium valproate?

Answer 7

100-200/10000; rising from 6/10000

Question 8

Apart from neural tube defects, what other risk does sodium valproate carry for the foetus?

Answer 8

• Craniofacial defects

- Effects on child’s intellectual development

Question 9

What are some features of foetal alcohol syndrome? (6)

Answer 9

• Facial deformities
• Lower IQ
• Neurodevelopmental delay
• Hearing
• Heart defects

Question 10

Is alcohol contraindicated in breastfeeding?

Answer 10

No; only if >8units a week.