PMH-C Exam A Complete Guide
Military Stressors:
- ✔️ Recent/upcoming deployment
- Potential lack of emotional support from partner
- Fear for welfare or self or partner
- Living without partner
- Single parenting
- Concerns about childcare
Inadequate Support:
- Location away from friends and family
- Possibility of no established relationships with recent move
- Lack of providers who understand military culture
- Lack of providers for beneficiaries
- Lack of providers who accept insurance
- Lack of peer support due to "army strong" mentality
- Lack of disclosure to others due to "small town"
- Lack of ability to provide peer support due to own needs
- Focus often on active duty member's psychological issues
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Key Figures and Organizations:
- Jane Honikman
- ✔️ Founder of PSI
- Established PSI in 1987.
,- Louis Victor Marce
- ✔️ French psychiatrist who wrote the first treatise on puerperal mental illness.
- James A. Hamilton
- ✔️ Father of Postpartum Psychiatric Illness
- Authored Postpartum Psychiatric Problems
- Founded the Marce Society
- Advocate for research, treatment, and social support.
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Organizations:
- DAD: Depression After Delivery (USA)
- APNI: Association for Post Natal Illness (England)
- PANDA: Post and Ante Natal Depression Association (Australia)
- Postpartum Education for Parents: Postpartum Education for Parents (USA)
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Mental Health Facts:
- Most important part of mental health for women, children, and families: ✔️ Social support
- Number of countries PSI has members in: ✔️ Over 40 countries
- Percentage of women who will experience postpartum depression: ✔️ 21%
- Percentage of pregnant women experiencing moderate to severe symptoms of depression and/or
anxiety: ✔️ 20%
- Percentage of pregnant women with psychiatric diagnosis who were treated: ✔️ Less than 86%
- Percentage of women on antidepressants who were symptomatic due to suboptimal treatment: ✔️
Over 50%
,- Definition of perinatal period: ✔️ The entire time frame from pregnancy through the first year after
giving birth
- Definition of PMAD: ✔️ Perinatal Mood (depression and bipolar) Anxiety (GAD, panic, OCD, PTSD)
Disorders
- Percentage of unplanned pregnancies: ✔️ 50%
- Definition of PMDD: ✔️ Premenstrual dysphoric disorder
- Sensitive to hormonal changes; risk factor for PMAD.
Disorders that classify as PMAD:
- ✔️ Depression
- ✔️ Anxiety and Panic disorder
- ✔️ OCD
- ✔️ PTSD
- ✔️ Perinatal Bipolar
- ✔️ Psychosis
---
Impact of Perinatal Depression:
- Most underdiagnosed obstetric complication in America.
- Related issues include:
- Increased costs of medical care
- Inappropriate medical care
- Child abuse and neglect
- Discontinuation of breastfeeding
- Family dysfunction
- Adversely affects early brain development
- Detection and diagnosis: ✔️ 40% of cases are detected and diagnosed
- Treatment: ✔️ 60% receive treatment
, Prevalence Rates:
- Prevalence for prenatal anxiety: ✔️ 15.8%
- Prevalence for postpartum anxiety: ✔️ 8% - 20%
- PMADs in fathers: ✔️ 1 in 10 men will experience anxiety/depression
Fathers with higher ACE scores reported more pregnancy-related anxiety than did fathers with lower
scores at all time points
Reported more depressive feelings during pregnancy
9.2% had depression prenatally
Maternal depression increased the risk of paternal depression
- Initial high after birth may give way to depression
- Masked male depression (substance use, irritable, aggressive)
- Distancing
- Distractions and habits
Medication ✔️50-75% relapse (depression and anxiety) after discontinuing medication while pregnant
Over 40% resume medication during pregnancy
The benefit out weights the risk when on medication during pregnancy
Normal Pregnancy symptoms ✔️Mood is labile, teary
Self esteem is normal
Sleep: bladder or heartburn may awaken. Can fall asleep
Military Stressors:
- ✔️ Recent/upcoming deployment
- Potential lack of emotional support from partner
- Fear for welfare or self or partner
- Living without partner
- Single parenting
- Concerns about childcare
Inadequate Support:
- Location away from friends and family
- Possibility of no established relationships with recent move
- Lack of providers who understand military culture
- Lack of providers for beneficiaries
- Lack of providers who accept insurance
- Lack of peer support due to "army strong" mentality
- Lack of disclosure to others due to "small town"
- Lack of ability to provide peer support due to own needs
- Focus often on active duty member's psychological issues
---
Key Figures and Organizations:
- Jane Honikman
- ✔️ Founder of PSI
- Established PSI in 1987.
,- Louis Victor Marce
- ✔️ French psychiatrist who wrote the first treatise on puerperal mental illness.
- James A. Hamilton
- ✔️ Father of Postpartum Psychiatric Illness
- Authored Postpartum Psychiatric Problems
- Founded the Marce Society
- Advocate for research, treatment, and social support.
---
Organizations:
- DAD: Depression After Delivery (USA)
- APNI: Association for Post Natal Illness (England)
- PANDA: Post and Ante Natal Depression Association (Australia)
- Postpartum Education for Parents: Postpartum Education for Parents (USA)
---
Mental Health Facts:
- Most important part of mental health for women, children, and families: ✔️ Social support
- Number of countries PSI has members in: ✔️ Over 40 countries
- Percentage of women who will experience postpartum depression: ✔️ 21%
- Percentage of pregnant women experiencing moderate to severe symptoms of depression and/or
anxiety: ✔️ 20%
- Percentage of pregnant women with psychiatric diagnosis who were treated: ✔️ Less than 86%
- Percentage of women on antidepressants who were symptomatic due to suboptimal treatment: ✔️
Over 50%
,- Definition of perinatal period: ✔️ The entire time frame from pregnancy through the first year after
giving birth
- Definition of PMAD: ✔️ Perinatal Mood (depression and bipolar) Anxiety (GAD, panic, OCD, PTSD)
Disorders
- Percentage of unplanned pregnancies: ✔️ 50%
- Definition of PMDD: ✔️ Premenstrual dysphoric disorder
- Sensitive to hormonal changes; risk factor for PMAD.
Disorders that classify as PMAD:
- ✔️ Depression
- ✔️ Anxiety and Panic disorder
- ✔️ OCD
- ✔️ PTSD
- ✔️ Perinatal Bipolar
- ✔️ Psychosis
---
Impact of Perinatal Depression:
- Most underdiagnosed obstetric complication in America.
- Related issues include:
- Increased costs of medical care
- Inappropriate medical care
- Child abuse and neglect
- Discontinuation of breastfeeding
- Family dysfunction
- Adversely affects early brain development
- Detection and diagnosis: ✔️ 40% of cases are detected and diagnosed
- Treatment: ✔️ 60% receive treatment
, Prevalence Rates:
- Prevalence for prenatal anxiety: ✔️ 15.8%
- Prevalence for postpartum anxiety: ✔️ 8% - 20%
- PMADs in fathers: ✔️ 1 in 10 men will experience anxiety/depression
Fathers with higher ACE scores reported more pregnancy-related anxiety than did fathers with lower
scores at all time points
Reported more depressive feelings during pregnancy
9.2% had depression prenatally
Maternal depression increased the risk of paternal depression
- Initial high after birth may give way to depression
- Masked male depression (substance use, irritable, aggressive)
- Distancing
- Distractions and habits
Medication ✔️50-75% relapse (depression and anxiety) after discontinuing medication while pregnant
Over 40% resume medication during pregnancy
The benefit out weights the risk when on medication during pregnancy
Normal Pregnancy symptoms ✔️Mood is labile, teary
Self esteem is normal
Sleep: bladder or heartburn may awaken. Can fall asleep
