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Mar 06, 2014
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Language: en
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Post-partum
Psychiatry
AL-Saleh, Yassin ,M. college of
medicine, KSU.
Objectives
To Identify the different types of
post-partum psychiatry .
To give an epidemiological data.
To determine the risk factors
associated with different types.
To review the clinical feature of
each type.
To learn how to manage each
disorder.
1- Post-partum depression.
(definition(
Postpartum depression is a major
depressive episode with an onset in
the first four weeks following
childbirth.
Postpartum depression Vs
postpartum blues (baby blue).
Baby blue last for two weeks after
delivery.
Why it is called baby blue?
1- Post-partum depression.
(epidemiology(
10-15% of new mothers develop
postpartum depression.
Only 10% seek for help.
CAUSES:
Unknown. (biological factor, genetic ,
hormonal, life stresses)
1- Post-partum depression.
(Risk factors(
Personal history of depression
Family history of depression
Unplanned pregnancy
Poor support from partner
Single parent
Depression during pregnancy
Complications during pregnancy
Pre-term birth
Poor social support
1- Post-partum depression.
(symptoms(
Lack of interest or pleasure in
activities.
Lack of appetite or pleasure in
eating .
Sleep disruption .
Fatigue or lack of motivation.
Feelings of guilt or worthlessness .
Poor concentration .
Persistent anxiety ↑.
Thoughts of death or suicide ↓.
1- Post-partum deperession.
(management(
Level of
depression
Treatment
Mild to moderate psychotherapy, cognitive therapy
Moderate to
severe
Serotonin re-uptake inhibitors (Fluoxetine,
Sertraline, Paroxetine)
Tricyclic antidepressants (Imipramine,
Nortriptyline, and others)
New generation antidepressants (Venlafaxine,
Buproprion, and others)
Mild to severe
Combined psychotherapy and antidepressant
medications
Severe depression Electroconvulsive therapy
2- Postpartum psychosis
about 0. 1-0.2% of new mothers.
condition is defined as an atypical
psychosis which may begin within the
first six months of delivery.
Presenting symptoms include severe
insomnia, agitation and restlessness,
hallucinations, paranoia and delusions
focused on the baby. Homicidal and
suicidal thought are not uncommon.
Consider as a medical emergency.
3-Postpartum obsessive
compulsive disorder
Condition characterized by many of
the typical symptoms of OCD,
however the obsessions and the
compulsion are more focused on
the baby and the patient's new role
and responsibilities of being a
mother.
4-Postpartum anxiety/panic
disorder
condition which characterized by
symptoms of intense anxiety or
panic and may involve many
somatic symptoms such:
cardiac palpitations, tachycardia,
tachypnea, dyspnea, hot or cold
flashes, chest pain, abdominal
pain, dizziness, tremor and feelings
of doom and helplessness.
Conclusion
Women should be followed during
post partum period, especially if
they have a history of depression
or depressive symptoms during
pregnancy.
Treatment should be multifactorial,
including consideration of
psychosocial as well as
pharmacologic options.