This blogpost is a compilation of random facts about peripartum mental health which is one of an important aspect of women care. As a health care provider it is pertinent to provide optimum care for the mental health of the woman. Mental health disorders are prevalent and a woman is vulnerable during pregnancy and in the post part period. According to MBRRACE Suicide is now considered a direct cause of maternal death.
This post should be used as an adjunct to your study material for this topic as only random facts are given here.
I hope this is helpful for you all.
Thanks
 |
Psychiatric Disorders
- Common up to 20%
- 3-5% severely affected
- 2015 MBRRACE almost quarter of deaths due to this in 6wks - 1year postpartum
- Psychotic disorders more common than another time in a woman’s life
- Peak onset <7days
- Highest rate of adverse consequences of antenatal exposure Sodium Valproate
- Postpartum psychosis most commonly associated with bipolar affective disorder
- Approximate risk of developing postnatal depression with h/o depression + 1st degree family member with h/o postnatal depression 40%
The most common mental problems during pregnancy
- Depression 12% Anxiety 13%
- Both also affect 15-20% woman in the first year after birth
Psychiatric Assessment vital screening tool
Risks short term or long term
Red Flags Symptoms
- Rapid alteration in mental status
- New symptoms Psychotic symptoms
- Thoughts of violent self harm New ideas
- Guilt Hopelessness
- Acts of violent self harm
- Not eating well Insomnia
- Psychomotor retardation
Suicide risk found → trigger urgent assessment
- Local safe-guarding + infant protection issues
Screening Tools
- Wholly questions
- Edinburgh depression scale most frequently used
- Sensitivity 34-100% Specificity 44-100% PPV 57% NPV 99%
- PHQ-9 Patient Health Questionnaire 0-3
- GAD-2 & 7 Anxiety Screening tools
- Cut off scores — Mild 5 Moderate 10 Severe 15
- GAD -7 Sensitivity 89% Specificity 82%
- Moderately effective for panic disorders, social anxiety disorders, post traumatic stress disorders
Indications for Referral
- Current illness with symptoms of psychosis, severe anxiety, severe depression, sociality, self-neglect, harm to others or significant interference with daily functioning
- H/o bipolar disorder / Schizophrenia
- Hi/o serious postpartum mental illness like puerperal psychosis
Referral considered
- Illness of moderate severity