NRl 606/l NR606l Midterml Exam:l
Diagnosisl andl Managementl inl Psychiatric-
Mentall Healthl IIl Practicuml Guidel
(Latestl 2026/l 2027l Update)l |l Qsl &l As|l
Gradel A|l 100%l Correctl (Verifiedl
Answers)-l Chamberlain
QUESTION
Whatl isl thel DSM-5l criterial forl perinatall OCD?
Answer:
Presencel ofl obsessions,l compulsions,l orl both:l
1.l Recurrentl andl persistentl thoughts,l urgesl orl imagesl thatl arel experienced,l atl somel
timel duringl thel disturbance,l asl intrusive,l unwanted,l andl thatl inl mostl individualsl causel
markedl anxietyl orl distress-l OBSESSIONS
2.)l Repetitivel behaviorsl (e.g.,l handl washing,l orderingl checking)l orl mentall actsl (e.g.,l
praying,l counting,l repeatingl wordsl silently)l thatl thel personl feelsl drivenl tol performl inl
responsel tol anl obsession,l orl accordingl tol thel rulesl thatl mustl bel appliedl rigidly.1.l
SAME2.l Thel behaviorsl orl mentall actsl arel aimedl atl preventingl orl reducingl distressl orl
preventingl somel dreadedl eventl orl situation.l However,l thesel behaviorsl orl mentall actsl
eitherl arel notl connectedl inl al realisticl wayl withl whatl theyl arel designedl tol neutralizel orl
preventl orl arel clearlyl excessive.
Thel obsessionsl orl compulsionsl arel timel consumingl (e.g.,l takel morel thanl 1l hourl perl
day)l orl causel clinicallyl significantl distressl orl impairmentl inl social,l occupational,l orl
otherl importantl areasl ofl functioning.
QUESTION
Whatl arel somel s/sl ofl perinatall OCD?
Answer:
,Commonl obsessionsl relatel tol fearsl ofl contaminatingl thel baby,l thel needl forl exactness,l
thoughtsl ofl aggressionl towardsl thel infant,l andl fearsl ofl infantl death,l whilel commonl
compulsionsl includel repetitivel handwashingl andl checkingl thel infantl (Beck,l 2021).l Ifl
intrusivel thoughtsl involvel fearsl ofl actingl aggressivelyl towardl thel infant,l mothersl fearl
beingl leftl alonel withl thel infantl orl mayl distancel themselvesl froml thel infantl tol avoidl
actingl onl thel thoughts.l Definedl obsessionsl asl "recurrentl andl persistentl thoughts,l urges,l
orl imagesl thatl arel experienced,l atl somel timel duringl thel disturbance,l asl intrusivel andl
unwanted,l andl thatl inl mostl individualsl causel markedl anxietyl orl distress."l Compulsionsl
werel definedl asl "repetitivel behaviorsl (e.g.,l handl washing,l orderingl ofl objects,l re-
checking)l orl mentall actsl (e.g.,l praying,l counting,l repeatingl wordsl silently)l thatl thel
individuall feelsl drivenl tol performl inl responsel tol anl obsessionl orl accordingl tol rulesl
thatl mustl bel appliedl rigidly"l (APA,l 2013,l p.l 237).l Withl compulsivel acts,l al personl
attemptsl tol decreasel anxietyl orl preventl al dreadedl event.l Thel obsessionsl andl
compulsionsl arel distressingl andl occurl morel thanl 1l hourl perl day.
QUESTION
O.C.D.l continued....
Answer:
Inl postpartuml OCD,l thesel intrusivel thoughtsl arel ego-dystonicl orl notl consideredl withinl
thel woman'sl realityl (Wenzel,l 2011).l Thel thoughtsl causel greatl distressl andl womenl arel
uncomfortablel talkingl withl othersl aboutl them.l Womenl withl OCDl arel oftenl afraidl ofl
beingl leftl alonel withl theirl infantsl andl arel hypervigilantl inl protectingl them.l Mostl
womenl withl postpartuml OCDl arel terrifiedl ofl revealingl theirl thoughtsl ofl harmingl theirl
infantsl tol anyonel becausel ofl shame,l guilt,l andl fearl thatl thel infantl willl bel takenl awayl
froml theml (Wenzel,l 2011).l Whenl womenl finallyl sharel theirl thoughts,l theyl oftenl telll
cliniciansl theyl wouldl neverl actl onl them.l Inl fact,l womenl usuallyl describel elaboratel
plansl tol avoidl situationsl inl whichl thel intrusivel thoughtsl mightl occur.l Forl example,l ifl al
womanl experiencesl repetitivel thoughtsl ofl cuttingl herl infantl withl al knife,l shel mayl havel
alll thel sharpl objectsl andl knivesl removedl froml herl homel andl keptl inl al locationl
unknownl tol her.l
Womenl inl thel peripartuml periodl arel approximatelyl 1.5-2l timesl morel likelyl tol
experiencel OCDl comparedl tol thel generall population,l andl upl tol 47%l ofl womenl withl
OCDl experiencel theirl firstl onsetl duringl thel peripartuml period.
QUESTION
,Howl wouldl youl treatl perinatall O.C.D.,l pharmacologicallyl andl non-pharmacologically?
Answer:
Firstl linel treatmentl wouldl bel anl SSRI,l likel Fluoxetine.
CBTl withl psycho-education
Cognitivel restructuring
Exposurel withl responsel prevention
QUESTION
Whatl arel thel babyl blues?
Answer:
Symptomsl thatl canl lastl froml daysl tol weeksl postl deliveryl duel tol thel drasticl dropl inl
hormonesl afterl thel placental isl delivered.l However,l ITl WILLl NOTl CAUSEl
IMPAIRMENT.l Thel bestl treatmentl isl selfl care,l emotionall supportl andl reassurancel froml
familyl andl friends,l eatl well,l askl forl help,l getl greatl amountl ofl rest.
QUESTION
Doesl babyl bluesl causel impairment?
Answer:
NOOOOOO
QUESTION
Perinatall mentall illnessl isl associatedl withl adversel outcomesl forl bothl thel pregnantl clientl
andl infant,l includingl preterml birth,l lowl birthl weight,l andl al higherl incidencel ofl
maternall substancel use.
Whatl arel somel complicationsl ofl smokingl duringl pregnancy?
Answer:
Lowl birthl weight
ectopicl pregnancy
fetall mortality,l placental privia,l placentall abruption,l stilll birthl andl pre-terml labor.
, Smoking-relatedl effectsl onl neonatesl includel suddenl infantl deathl syndromel andl birthl
malformationsl suchl asl orall cleftsl andl neurall tubel defects,l whereasl effectsl onl infants,l
children,l andl adolescentsl includel asthma,l cognitivel impairment,l lowerl respiratoryl illness,l
attentionl deficitl hyperactivityl disorderl (ADHD),l andl centrall nervousl systeml tumors
QUESTION
Whatl isl thel DSM-5l criterial forl perinatall psychosis?
Answer:
Thel DSM-5-TRl (APA,l 2022)l recognizesl perinatall psychosisl asl al "briefl psychoticl
disorderl withl peripartuml onset"l whenl symptomsl presentl suddenlyl duringl pregnancyl orl
withinl thel firstl 4l weeksl afterl birthl andl lastl atl leastl onel dayl butl nol morel thanl onel
month.l Thel patientl needsl tol onlyl havel ONEl ofl thel followingl symptoms
QUESTION
Whatl arel s/sl ofl perinatall psychosis?
Answer:
·Postpartuml psychosisl presentsl withl atl leastl onel ofl thel followingl symptoms:l delusions,l
hallucinations,l disorganizedl speech,l andl grosslyl disorganizedl orl catatonicl behaviorl
(Stephenl &l Lui,l 2021).l
Suicidel andl infanticidel arel primaryl concerns.l Hallucinationsl orl delusionsl relatedl tol thel
infantl arel common.l Forl example,l womenl mayl experiencel delusionsl thatl someonel willl
harml orl killl theirl infant,l thatl thel infantl isl thel devil,l orl thatl thel infantl belongsl tol
someonel else.l Theyl mayl experiencel commandl hallucinationsl tol harml orl killl theirl
infantsl whichl mayl seeml reasonablel orl appropriatel tol thel clientl (Beck,l 2021).l
THISl ISl Al PSYCHIATRICl EMERGENCYl ANDl THEl MOMMYl NEEDSl IMMEDIATEl
HOSPITALIZATION.l
Inl PPP,l however,l intrusivel thoughtsl ofl harmingl thel infantl arel ego-syntonicl orl consistentl
withl thel woman'sl reality.l Womenl withl PPPl dol notl experiencel distressl surroundingl thesel
thoughts,l andl theyl feell comfortablel discussingl theml withl others.l Becausel theyl
experiencel delusionsl andl hallucinationsl (Spinelli,l 2005),l therel isl anl increasedl likelihoodl
thatl psychoticl womenl willl actl onl suchl thoughts.
QUESTION
Whatl isl thel treatmentl forl perinatall psychosis?
Diagnosisl andl Managementl inl Psychiatric-
Mentall Healthl IIl Practicuml Guidel
(Latestl 2026/l 2027l Update)l |l Qsl &l As|l
Gradel A|l 100%l Correctl (Verifiedl
Answers)-l Chamberlain
QUESTION
Whatl isl thel DSM-5l criterial forl perinatall OCD?
Answer:
Presencel ofl obsessions,l compulsions,l orl both:l
1.l Recurrentl andl persistentl thoughts,l urgesl orl imagesl thatl arel experienced,l atl somel
timel duringl thel disturbance,l asl intrusive,l unwanted,l andl thatl inl mostl individualsl causel
markedl anxietyl orl distress-l OBSESSIONS
2.)l Repetitivel behaviorsl (e.g.,l handl washing,l orderingl checking)l orl mentall actsl (e.g.,l
praying,l counting,l repeatingl wordsl silently)l thatl thel personl feelsl drivenl tol performl inl
responsel tol anl obsession,l orl accordingl tol thel rulesl thatl mustl bel appliedl rigidly.1.l
SAME2.l Thel behaviorsl orl mentall actsl arel aimedl atl preventingl orl reducingl distressl orl
preventingl somel dreadedl eventl orl situation.l However,l thesel behaviorsl orl mentall actsl
eitherl arel notl connectedl inl al realisticl wayl withl whatl theyl arel designedl tol neutralizel orl
preventl orl arel clearlyl excessive.
Thel obsessionsl orl compulsionsl arel timel consumingl (e.g.,l takel morel thanl 1l hourl perl
day)l orl causel clinicallyl significantl distressl orl impairmentl inl social,l occupational,l orl
otherl importantl areasl ofl functioning.
QUESTION
Whatl arel somel s/sl ofl perinatall OCD?
Answer:
,Commonl obsessionsl relatel tol fearsl ofl contaminatingl thel baby,l thel needl forl exactness,l
thoughtsl ofl aggressionl towardsl thel infant,l andl fearsl ofl infantl death,l whilel commonl
compulsionsl includel repetitivel handwashingl andl checkingl thel infantl (Beck,l 2021).l Ifl
intrusivel thoughtsl involvel fearsl ofl actingl aggressivelyl towardl thel infant,l mothersl fearl
beingl leftl alonel withl thel infantl orl mayl distancel themselvesl froml thel infantl tol avoidl
actingl onl thel thoughts.l Definedl obsessionsl asl "recurrentl andl persistentl thoughts,l urges,l
orl imagesl thatl arel experienced,l atl somel timel duringl thel disturbance,l asl intrusivel andl
unwanted,l andl thatl inl mostl individualsl causel markedl anxietyl orl distress."l Compulsionsl
werel definedl asl "repetitivel behaviorsl (e.g.,l handl washing,l orderingl ofl objects,l re-
checking)l orl mentall actsl (e.g.,l praying,l counting,l repeatingl wordsl silently)l thatl thel
individuall feelsl drivenl tol performl inl responsel tol anl obsessionl orl accordingl tol rulesl
thatl mustl bel appliedl rigidly"l (APA,l 2013,l p.l 237).l Withl compulsivel acts,l al personl
attemptsl tol decreasel anxietyl orl preventl al dreadedl event.l Thel obsessionsl andl
compulsionsl arel distressingl andl occurl morel thanl 1l hourl perl day.
QUESTION
O.C.D.l continued....
Answer:
Inl postpartuml OCD,l thesel intrusivel thoughtsl arel ego-dystonicl orl notl consideredl withinl
thel woman'sl realityl (Wenzel,l 2011).l Thel thoughtsl causel greatl distressl andl womenl arel
uncomfortablel talkingl withl othersl aboutl them.l Womenl withl OCDl arel oftenl afraidl ofl
beingl leftl alonel withl theirl infantsl andl arel hypervigilantl inl protectingl them.l Mostl
womenl withl postpartuml OCDl arel terrifiedl ofl revealingl theirl thoughtsl ofl harmingl theirl
infantsl tol anyonel becausel ofl shame,l guilt,l andl fearl thatl thel infantl willl bel takenl awayl
froml theml (Wenzel,l 2011).l Whenl womenl finallyl sharel theirl thoughts,l theyl oftenl telll
cliniciansl theyl wouldl neverl actl onl them.l Inl fact,l womenl usuallyl describel elaboratel
plansl tol avoidl situationsl inl whichl thel intrusivel thoughtsl mightl occur.l Forl example,l ifl al
womanl experiencesl repetitivel thoughtsl ofl cuttingl herl infantl withl al knife,l shel mayl havel
alll thel sharpl objectsl andl knivesl removedl froml herl homel andl keptl inl al locationl
unknownl tol her.l
Womenl inl thel peripartuml periodl arel approximatelyl 1.5-2l timesl morel likelyl tol
experiencel OCDl comparedl tol thel generall population,l andl upl tol 47%l ofl womenl withl
OCDl experiencel theirl firstl onsetl duringl thel peripartuml period.
QUESTION
,Howl wouldl youl treatl perinatall O.C.D.,l pharmacologicallyl andl non-pharmacologically?
Answer:
Firstl linel treatmentl wouldl bel anl SSRI,l likel Fluoxetine.
CBTl withl psycho-education
Cognitivel restructuring
Exposurel withl responsel prevention
QUESTION
Whatl arel thel babyl blues?
Answer:
Symptomsl thatl canl lastl froml daysl tol weeksl postl deliveryl duel tol thel drasticl dropl inl
hormonesl afterl thel placental isl delivered.l However,l ITl WILLl NOTl CAUSEl
IMPAIRMENT.l Thel bestl treatmentl isl selfl care,l emotionall supportl andl reassurancel froml
familyl andl friends,l eatl well,l askl forl help,l getl greatl amountl ofl rest.
QUESTION
Doesl babyl bluesl causel impairment?
Answer:
NOOOOOO
QUESTION
Perinatall mentall illnessl isl associatedl withl adversel outcomesl forl bothl thel pregnantl clientl
andl infant,l includingl preterml birth,l lowl birthl weight,l andl al higherl incidencel ofl
maternall substancel use.
Whatl arel somel complicationsl ofl smokingl duringl pregnancy?
Answer:
Lowl birthl weight
ectopicl pregnancy
fetall mortality,l placental privia,l placentall abruption,l stilll birthl andl pre-terml labor.
, Smoking-relatedl effectsl onl neonatesl includel suddenl infantl deathl syndromel andl birthl
malformationsl suchl asl orall cleftsl andl neurall tubel defects,l whereasl effectsl onl infants,l
children,l andl adolescentsl includel asthma,l cognitivel impairment,l lowerl respiratoryl illness,l
attentionl deficitl hyperactivityl disorderl (ADHD),l andl centrall nervousl systeml tumors
QUESTION
Whatl isl thel DSM-5l criterial forl perinatall psychosis?
Answer:
Thel DSM-5-TRl (APA,l 2022)l recognizesl perinatall psychosisl asl al "briefl psychoticl
disorderl withl peripartuml onset"l whenl symptomsl presentl suddenlyl duringl pregnancyl orl
withinl thel firstl 4l weeksl afterl birthl andl lastl atl leastl onel dayl butl nol morel thanl onel
month.l Thel patientl needsl tol onlyl havel ONEl ofl thel followingl symptoms
QUESTION
Whatl arel s/sl ofl perinatall psychosis?
Answer:
·Postpartuml psychosisl presentsl withl atl leastl onel ofl thel followingl symptoms:l delusions,l
hallucinations,l disorganizedl speech,l andl grosslyl disorganizedl orl catatonicl behaviorl
(Stephenl &l Lui,l 2021).l
Suicidel andl infanticidel arel primaryl concerns.l Hallucinationsl orl delusionsl relatedl tol thel
infantl arel common.l Forl example,l womenl mayl experiencel delusionsl thatl someonel willl
harml orl killl theirl infant,l thatl thel infantl isl thel devil,l orl thatl thel infantl belongsl tol
someonel else.l Theyl mayl experiencel commandl hallucinationsl tol harml orl killl theirl
infantsl whichl mayl seeml reasonablel orl appropriatel tol thel clientl (Beck,l 2021).l
THISl ISl Al PSYCHIATRICl EMERGENCYl ANDl THEl MOMMYl NEEDSl IMMEDIATEl
HOSPITALIZATION.l
Inl PPP,l however,l intrusivel thoughtsl ofl harmingl thel infantl arel ego-syntonicl orl consistentl
withl thel woman'sl reality.l Womenl withl PPPl dol notl experiencel distressl surroundingl thesel
thoughts,l andl theyl feell comfortablel discussingl theml withl others.l Becausel theyl
experiencel delusionsl andl hallucinationsl (Spinelli,l 2005),l therel isl anl increasedl likelihoodl
thatl psychoticl womenl willl actl onl suchl thoughts.
QUESTION
Whatl isl thel treatmentl forl perinatall psychosis?
