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Peripartum MH

Mental health Peripartum

TermDefinition
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
Created by: akimball80
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