click below
click below
Normal Size Small Size show me how
Peripartum MH
Mental health Peripartum
| Term | Definition |
|---|---|
| Baby Blues | Duration - <10 days Onset - within 2-3 days postpartum Prevalence - 80% Severity - mild dysfunction SI - Not present |
| Postpartum Depression | Duration - >2 weeks Onset - w/in 1st month postpartum to 1 year Prevalence - 10-15% Severity - moderate to severe dysfunction SI - may be present |
| Tools for Depression Screening during the Perinatal Period | Postpartum Depression Screening Scale Edinburgh Postnatal Depression Scale |
| Treatment for Depression during the Perinatal Period | Medications Psychosocial Interventions Therapy - CBT or IPT ECT |
| Common MH disorders in the Perinatal Period | Anxiety - GAD, Panic Disorder, PTSD, OCD Bipolar Schizophrenia |
| Treatment for Anxiety during Perinatal Period | CBT is first line Coping with Anxiety through Living Mindfully (CALM) pregnancy intervention Aromatherapy Massage |
| Tools for Anxiety Screening during the Perinatal Period | Postpartum Specific Anxiety Scale Postpartum Worry Scale-Revised Pregnancy Anxiety Scale Perinatal Anxiety Screening Scale Perinatal Obsessive Compulsive Scale Pregnancy Related Anxiety Questionnaire |
| Impacts of Perinatal MH on infant | Increase stress hormones - physical/neurological development Decreased maternal nutrition, reduce breast milk supply BH problems, lower IQ Sleeping and feeding patterns/quality developmental delays low birth weight attachment difficulties |
| Pregnancy & MH | 20% prevalance preexisting versus new onset normal feelings of anxiety/worry vs more severe - depression, bipolar d/o, psychosis substance misuse is common |
| Risk factors for PPD (Postpartum Depression) | hx of depression, including hx of PPD current depressive symptoms hx of physical or sexual abuse unplanned or unwanted pregnancy lack of social and/or financial support intimate partner violence complications, genetics, diabetes |
| Bipolar Disorder in the Perinatal period | mood - depressed or mixed pts usually stop meds in first trimester sleep challenges ppp - postpartum pscyhosis increase risk of preeclampsia & preterm labor |
| Schizophrenia in the Perinatal period | increase risk of unwanted pregnancy increase risk of IPV single increase risk of MH symptoms & Substance use late prenatal care coexisting medical problems 5x higher rate of mortality |
| Treatment for Schizophrenia during the Perinatal Period | medications access to resources Case management Education - labor/delivery & parenting classes assess for psychotic content, especially in relation to the child |
| Substance use in Pregnancy | difficult to quit screen w/o judgment risks to infant and pregnancy outcomes are unique Opioid use disorder - continue tx versus withdrawal Neonatal abstinence syndrome |
| Screening tools for Substance use in Pregnancy | T-ACE TWEAK 4 P's Plus |
| Puerperal Psychosis (PPP) | Very rare (1-2/1000 births) w/ in 2 weeks post delivery acute onset Strongest risk - hx bipolar d/o 20-30% primiparous increase risk, recurrence self harm, SI |
| Puerperal Psychosis (PPP) Presentation and Symptoms | mania, depression with psychotic features or mixed state difficulty sleeping, mood changes, obsessive/intrusive thoughts about harming baby and progresses to delusions, hallucinations, and disorganization. |
| Treatment for Puerperal Psychosis (PPP) | Psychiatric Emergency!! INPATIENT restore sleep - Benzos meds - Antipsychotics, Lithium ECT Support - parenting classes, video-interaction feedback, baby massage |