Perinatal Mental Health Exam 247 Questions with Verified
Answers.
What is a PMAD? - Correct Answer A perinatal mood and anxiety disorder (not just
PPD!)
Define the perinatal period. - Correct Answer Time from conception through 1st year
after giving birth.
Define the prenatal or antenatal time - Correct Answer During pregnancy
Define the postpartum or postnatal time - Correct Answer 1st year after giving birth
What does PMAD mean? - Correct Answer Perinatal mood (depression, bipolar,
psychosis) anxiety (ocd, panic, had, ptsd) disorders (impact daily functioning).
Can occur at anytime in life but increased risk in perinatal period and symptoms have
unique presentation.
How many infants annually are born to depressed mothers? - Correct Answer
400,000...making perinatal depression the most under diagnosed obstetric complication
in America
PMADs can affect... - Correct Answer Anyone!
They do not discriminate. Can affect anyone. Socioeconomic status is NOT protective
_ in _ women are affected by perinatal depression - Correct Answer 1 in 7 women
Percentage of pregnancy induced HTN vs pre-eclampsia vs gestational diabetes vs
PMADs? - Correct Answer 6-8% PIH, 6-8% pre-eclampsia, 6% gestational diabetes,
21% PMADs
_ in _ men are affected by perinatal depression - Correct Answer 1 in 10 men
Risks of untreated PMADs - Correct Answer Relationship problems, poor adherence to
medical care, exacerbation of chronic medical issues, loss of financial resources,
disability, child neglect/abuse, developmental delays, tobacco/alcohol, drug use,
Suicide, homicide
How many pregnancies are unplanned? - Correct Answer 50%
Not all pregnancies are planned, wanted. Not all pregnancies end with a health baby or
fulfillment.
,Etiology of PPD? - Correct Answer Genetic predisposition, biological sensitivity to
hormonal changes, social/environmental (Hx of trauma or poor social support),
psychological (relationship with own mom, self image/perfectionism)
Cultural considerations of ppd - Correct Answer -in some cultures mothers may not feel
safe to express needs or seek help.
-may report symptoms differently based on culture
What did the landmark study on PPD show? - Correct Answer 22% of women had
depression during first year postpartum: 26% started before pregnancy, 33% during
pregnancy, 40% during postpartum
Of the 22% of postpartum mothers - Correct Answer 68% had unipolar depression
66% had MDD or combo with GAD
22% bipolar depression
19% had thoughts of harming selves
Prenatal depression relapse rate with meds and without meds - Correct Answer 26%
who continued meds relapsed during pregnancy while 68% who stopped meds relapsed
Higher relapse rate if you DC meds
Percent of fathers with PPD? - Correct Answer 10%
Depression in men: timing, symptoms - Correct Answer Peaks at 3-6 months
postpartum
May not be sad "masked" and irritable, aggressive, hostile, acting out, checked out,
distractions
Do men seek help for their depression? - Correct Answer Not often. Only 3% sought
help.
Men are likely to under report symptoms
Single mothers vs single fathers - Correct Answer Single mothers: higher risk of
maltreatment. Twice as likely than mothers with partners to have depression.
Single fathers: have 3 times mortality rate than single mothers or partnered parents.
Trans gestational parents - Correct Answer Needs research to determine prevalence.
Baseline depression and anxiety higher than adult average already.
,Other people at risk - Correct Answer Non-gestational parents also at risk for PMADs.
Pregnancy VS Depression - Correct Answer Pregnancy-tearful, labor. No change in self
esteem. Sleep disrupted due to bladder. No SI. Tire but rest restores, appropriate worry,
joy, increase appetite
Depression: irritable, gloom, rage, low self esteem/guilt. Sleep changes, SI. Fatigue and
no restoration of rest. Anhedonia
Characteristics of baby blues - Correct Answer 60-80% new moms affected
Due to hormone fluctuation/sleep deprivation
Lasts 2 days-2 weeks. Peaks 3-5 d.
Symptoms of baby blues - Correct Answer Tearfulness, liability, exhaustion
Predominately happy, self esteem unchanged
Unrelated to stress or prior psych history
Consider timing, onset, severity, duration, chronicity when differentiation between PPD
and baby blues
Major unipolar depression with peripartum onset DSM criteria - Correct Answer 5 or
more symptoms present for at least 2 weeks
Depressed mood most of day
Loss of interest/joy
Weight change or appetite disturbance
Sleep disturbance
Psychomotor agitation
Fatigue
Poor focus
Worthless feelings
Excessive guilty
Recurrent thoughts of death/suicide
perinatal anxiety disorders - Correct Answer Includes GAD, panic
GAD DSM-5 Criteria - Correct Answer Excessive worry and anxiety (about ones own
and babies needs)
Difficulty controlling worry
, Agitation, irritable
Restless, feeling on edge
Poor concentration
Fatigue, sleep disturbance (insomnia)
Increased somatic symptoms-muscle tension, palpitations, GI, SOB
Prevalence of perinatal anxiety - Correct Answer 15%
Estimates between 8-20%
Panic disorder dsm criteria - Correct Answer Episodes of intense fear peaking in
minutes
SOB, chest pain, choking, dizzy
Hot/cold flash, rapid HR, numbness
Restless, agitation, irritable
Excessive fear/worry
Fear of going crazy or another attack
No trigger sometimes
3 greatest fears in panic disorder - Correct Answer Going crazy, death, losing control
Perinatal OCD - Correct Answer Obsessions defined by recurrent and persistent
thoughts, urges, impulses that are intrusive and unwanted and cause anxiety.
Compulsions are defined by repetitive behaviors that the individual feels driven to
perform in response to the obsession. Behaviors or mental acts are aimed at preventing
or reducing anxiety or distress.
Perinatal women how many times greater risk for ocd than general population?
____% had ocd onset in prenatal period - Correct Answer 1.5-2 times increase risk
32% had ocd onset in perinatal period