Postnatal Psych

Question 1

Mother tries to kill baby to save it from doom?

Answer 1

Puerperal psychosis

Question 2

Mother thinks baby is evil/ possessed/abnormal

Answer 2

Puerperal psychosis

Question 3

How long to treat puerperal psychosis?

Answer 3

Most recover in 6-12 weeks but need to give treatment for 6 months

Question 4

How common are baby blues

Answer 4

50-75% of mothers have it

Normal altho distressing feeling

Question 5

What is a normal condition for mothers to experience post natally?

Answer 5

Baby blues

Question 6

Women has low mood within a week of giving birth

Answer 6

baby blues

Question 7

How to treat baby blues?

Answer 7

Reassurance and support

Question 8

Which type of mothers are baby blues more common in?

Answer 8

Primipara women - giving birth for the first time

Question 11

How to manage Post partum depression?

Answer 11

CBT

then specific preferred SSRI (breastfeeding)
- sertraline
- paroxetine

Question 11

A women says her mood is all over the place, anxious, tearful, cant sleep 3 days after giving birth? What is the diagnosis

Answer 11

Baby blues

Question 13

puerperal psychosis features?

Answer 13

Severe mood swings - similar vibes to bipolar

disordered perception - auditory hallucinations / delusions

Question 14

How to manage puerperal psychosis?

Answer 14

Admission if <12 since childbirth

Use antipsychotics + benzo for agitation

2nd line - antidepressants

Question 15

How to screen someone who is giving a history indicative of PDD?

• what number indicates post natal depression

Answer 15

Edinburgh post natal depression scale

Score 12+ = likely depressive episode

Question 16

baby blues but they have lasted more than 2 weeks?

Answer 16

Then it needs to be screened for post partum depression using the edinburgh depression scale

Question 17

What is the common onset of puerperal psychosis?

Answer 17

2-3 weeks following birth

Question 18

Symptoms of PDD?

Answer 18

Low mood, anergia, anhedonia

Biological : poor sleep, appetite, concentration

Question 19

Severe PDD?

Answer 19

Admission can be required

Question 20

% of mothers with PDD?

Answer 20

10%

Question 21

When does PDD present?

Answer 21

6-8 weeks post partum

anywhere between 4 weeks - 1 year

Question 22

% risk of recurrence for puerperal psychosis?

Answer 22

50%

especially if next pregnancy is in 2 years

Question 23

Which antipsychotics can be given to postpartum women (+good for breastfeeding mums)

Answer 23

Olanzapine
Quetiapine

(Aripiprazole can reduce levels of the hormone prolactin. This can result in some individuals tbeing unable to produce enough breast milk.)