Perinatal
Mental Health exam
Questions with
Verified Answers
A perinatal mood and anxiety disorder (not just PPD!) - ✔✔- ACTUAL ANSWER- What is a
PMAD?
Time from conception through 1st year after giving birth. - ✔✔- ACTUAL ANSWER- Define the
perinatal period.
During pregnancy - ✔✔- ACTUAL ANSWER- Define the prenatal or antenatal time
1st year after giving birth - ✔✔- ACTUAL ANSWER- Define the postpartum or postnatal time
,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. - ✔✔- ACTUAL ANSWER- What does PMAD mean?
400,000...making perinatal depression the most under diagnosed obstetric complication in
America - ✔✔- ACTUAL ANSWER- How many infants annually are born to depressed
mothers?
Anyone!
They do not discriminate. Can affect anyone. Socioeconomic status is NOT protective - ✔✔-
ACTUAL ANSWER- PMADs can affect...
1 in 7 women - ✔✔- ACTUAL ANSWER- _ in _ women are affected by perinatal depression
6-8% PIH, 6-8% pre-eclampsia, 6% gestational diabetes, 21% PMADs - ✔✔- ACTUAL
ANSWER- Percentage of pregnancy induced HTN vs pre-eclampsia vs gestational diabetes vs
PMADs?
1 in 10 men - ✔✔- ACTUAL ANSWER- _ in _ men are affected by perinatal depression
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 - ✔✔- ACTUAL ANSWER- Risks of untreated
PMADs
50%
Not all pregnancies are planned, wanted. Not all pregnancies end with a health baby or
fulfillment. - ✔✔- ACTUAL ANSWER- How many pregnancies are unplanned?
Genetic predisposition, biological sensitivity to hormonal changes, social/environmental (Hx of
trauma or poor social support), psychological (relationship with own mom, self
image/perfectionism) - ✔✔- ACTUAL ANSWER- Etiology of PPD?
-in some cultures mothers may not feel safe to express needs or seek help.
-may report symptoms differently based on culture - ✔✔- ACTUAL ANSWER- Cultural
considerations of ppd
22% of women had depression during first year postpartum: 26% started before pregnancy,
33% during pregnancy, 40% during postpartum - ✔✔- ACTUAL ANSWER- What did the
landmark study on PPD show?
,68% had unipolar depression
66% had MDD or combo with GAD
22% bipolar depression
19% had thoughts of harming selves - ✔✔- ACTUAL ANSWER- Of the 22% of postpartum
mothers
26% who continued meds relapsed during pregnancy while 68% who stopped meds relapsed
Higher relapse rate if you DC meds - ✔✔- ACTUAL ANSWER- Prenatal depression relapse
rate with meds and without meds
10% - ✔✔- ACTUAL ANSWER- Percent of fathers with PPD?
Peaks at 3-6 months postpartum
May not be sad "masked" and irritable, aggressive, hostile, acting out, checked out, distractions
- ✔✔- ACTUAL ANSWER- Depression in men: timing, symptoms
Not often. Only 3% sought help.
Men are likely to under report symptoms - ✔✔- ACTUAL ANSWER- Do men seek help for their
depression?
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. - ✔✔-
ACTUAL ANSWER- Single mothers vs single fathers
Needs research to determine prevalence. Baseline depression and anxiety higher than adult
average already. - ✔✔- ACTUAL ANSWER- Trans gestational parents
Non-gestational parents also at risk for PMADs. - ✔✔- ACTUAL ANSWER- Other people at risk
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 - ✔✔- ACTUAL ANSWER- Pregnancy VS Depression
, 60-80% new moms affected
Due to hormone fluctuation/sleep deprivation
Lasts 2 days-2 weeks. Peaks 3-5 d. - ✔✔- ACTUAL ANSWER- Characteristics of baby blues
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 - ✔✔- ACTUAL ANSWER- Symptoms of baby blues
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 - ✔✔- ACTUAL ANSWER- Major unipolar depression with
peripartum onset DSM criteria
Includes GAD, panic - ✔✔- ACTUAL ANSWER- perinatal anxiety disorders
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)
Mental Health exam
Questions with
Verified Answers
A perinatal mood and anxiety disorder (not just PPD!) - ✔✔- ACTUAL ANSWER- What is a
PMAD?
Time from conception through 1st year after giving birth. - ✔✔- ACTUAL ANSWER- Define the
perinatal period.
During pregnancy - ✔✔- ACTUAL ANSWER- Define the prenatal or antenatal time
1st year after giving birth - ✔✔- ACTUAL ANSWER- Define the postpartum or postnatal time
,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. - ✔✔- ACTUAL ANSWER- What does PMAD mean?
400,000...making perinatal depression the most under diagnosed obstetric complication in
America - ✔✔- ACTUAL ANSWER- How many infants annually are born to depressed
mothers?
Anyone!
They do not discriminate. Can affect anyone. Socioeconomic status is NOT protective - ✔✔-
ACTUAL ANSWER- PMADs can affect...
1 in 7 women - ✔✔- ACTUAL ANSWER- _ in _ women are affected by perinatal depression
6-8% PIH, 6-8% pre-eclampsia, 6% gestational diabetes, 21% PMADs - ✔✔- ACTUAL
ANSWER- Percentage of pregnancy induced HTN vs pre-eclampsia vs gestational diabetes vs
PMADs?
1 in 10 men - ✔✔- ACTUAL ANSWER- _ in _ men are affected by perinatal depression
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 - ✔✔- ACTUAL ANSWER- Risks of untreated
PMADs
50%
Not all pregnancies are planned, wanted. Not all pregnancies end with a health baby or
fulfillment. - ✔✔- ACTUAL ANSWER- How many pregnancies are unplanned?
Genetic predisposition, biological sensitivity to hormonal changes, social/environmental (Hx of
trauma or poor social support), psychological (relationship with own mom, self
image/perfectionism) - ✔✔- ACTUAL ANSWER- Etiology of PPD?
-in some cultures mothers may not feel safe to express needs or seek help.
-may report symptoms differently based on culture - ✔✔- ACTUAL ANSWER- Cultural
considerations of ppd
22% of women had depression during first year postpartum: 26% started before pregnancy,
33% during pregnancy, 40% during postpartum - ✔✔- ACTUAL ANSWER- What did the
landmark study on PPD show?
,68% had unipolar depression
66% had MDD or combo with GAD
22% bipolar depression
19% had thoughts of harming selves - ✔✔- ACTUAL ANSWER- Of the 22% of postpartum
mothers
26% who continued meds relapsed during pregnancy while 68% who stopped meds relapsed
Higher relapse rate if you DC meds - ✔✔- ACTUAL ANSWER- Prenatal depression relapse
rate with meds and without meds
10% - ✔✔- ACTUAL ANSWER- Percent of fathers with PPD?
Peaks at 3-6 months postpartum
May not be sad "masked" and irritable, aggressive, hostile, acting out, checked out, distractions
- ✔✔- ACTUAL ANSWER- Depression in men: timing, symptoms
Not often. Only 3% sought help.
Men are likely to under report symptoms - ✔✔- ACTUAL ANSWER- Do men seek help for their
depression?
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. - ✔✔-
ACTUAL ANSWER- Single mothers vs single fathers
Needs research to determine prevalence. Baseline depression and anxiety higher than adult
average already. - ✔✔- ACTUAL ANSWER- Trans gestational parents
Non-gestational parents also at risk for PMADs. - ✔✔- ACTUAL ANSWER- Other people at risk
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 - ✔✔- ACTUAL ANSWER- Pregnancy VS Depression
, 60-80% new moms affected
Due to hormone fluctuation/sleep deprivation
Lasts 2 days-2 weeks. Peaks 3-5 d. - ✔✔- ACTUAL ANSWER- Characteristics of baby blues
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 - ✔✔- ACTUAL ANSWER- Symptoms of baby blues
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 - ✔✔- ACTUAL ANSWER- Major unipolar depression with
peripartum onset DSM criteria
Includes GAD, panic - ✔✔- ACTUAL ANSWER- perinatal anxiety disorders
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)
