Peripartum mood disturbances screening: Difference between revisions

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==Screening==
==Screening==
Screening of peripartum mood disturbances includes:
Screening of peripartum mood disturbances includes:<ref name="pmid16724884">{{cite journal |vauthors=Sit D, Rothschild AJ, Wisner KL |title=A review of postpartum psychosis |journal=J Womens Health (Larchmt) |volume=15 |issue=4 |pages=352–68 |date=May 2006 |pmid=16724884 |pmc=3109493 |doi=10.1089/jwh.2006.15.352 |url=}}</ref>


*Woman at-risk for [[postpartum]] [[psychosis]] should see a [[psychiatrist]] even before [[delivery]] to discuss treatment options to prevent [[illness]] during the delivery and [[postpartum]] period.
*Woman at-risk for [[postpartum]] [[psychosis]] should see a [[psychiatrist]] even before [[delivery]] to discuss treatment options to prevent [[illness]] during the delivery and [[postpartum]] period.
Line 16: Line 16:
**[[Hallucinations]] in the new mother.
**[[Hallucinations]] in the new mother.
*6-week obstetrical follow-up appointment, it is highly recommended that [[physicians]] should inquire about [[symptoms]] of [[postpartum]] [[psychosis]].
*6-week obstetrical follow-up appointment, it is highly recommended that [[physicians]] should inquire about [[symptoms]] of [[postpartum]] [[psychosis]].
*If the [[patient]] expresses red flags like difficulty caring for her child, confusion, poor self-care or threats to harm herself or others, a [[psychiatric]] referral should be made as soon as possible.<ref name="pmid16724884">{{cite journal |vauthors=Sit D, Rothschild AJ, Wisner KL |title=A review of postpartum psychosis |journal=J Womens Health (Larchmt) |volume=15 |issue=4 |pages=352–68 |date=May 2006 |pmid=16724884 |pmc=3109493 |doi=10.1089/jwh.2006.15.352 |url=}}</ref>
*If the [[patient]] expresses red flags like difficulty caring for her child, confusion, poor self-care or threats to harm herself or others, a [[psychiatric]] referral should be made as soon as possible.





Revision as of 23:46, 3 August 2021

Peripartum mood disturbances Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunita Kumawat, M.B.B.S[2]

Overview

It is critical to identify pregnant females and new mothers with peripartum mood disturbances, because if left unidentified and untreated it may lead to devastating consequences. Several screening tools are available for postpartum depression and for postpartum psychosis, if a patient has risk factors in personal hitory or obstetrical history, then she should visit her physician at the scheduled time for the assessment of mental health. There is no specific guideline for screening of postpartum blues.

Screening

Screening of peripartum mood disturbances includes:[1]

  • Woman at-risk for postpartum psychosis should see a psychiatrist even before delivery to discuss treatment options to prevent illness during the delivery and postpartum period.
  • In the first 2-4 weeks postpartum, the woman and her family should contact a physician if they find any of these symptoms,like
  • 6-week obstetrical follow-up appointment, it is highly recommended that physicians should inquire about symptoms of postpartum psychosis.
  • If the patient expresses red flags like difficulty caring for her child, confusion, poor self-care or threats to harm herself or others, a psychiatric referral should be made as soon as possible.


Depression Screening Tools

  • A variety of depression screening tools are available, their specificity ranges from 77% to 100%, but sensitivity varies and is the deciding factor in choosing the depression screening tool.
  • The most sensitive tools are
    • Edinburgh Postnatal Depression Scale
    • Postpartum Depression Screening Scale
    • Patient Health Questionnaire-9.


Other less sensitive and not so commonly used screening tools are given in the table below[2]

Depression screenings tools and their Sensitivity/Specificity
Screening tool Sensitivity/Specificity
Edinburgh postnatal depression scale Sensitivity:59-100%, Specificity:49-100%
Postpartum Depression Screening Scale Sensitivity:91-94%, Specificity:72-98%
Patient Health Questionnaire-9 Sensitivity:75%, Specificity:90%
Beck Depression Inventory Sensitivity:47.6-82%, Specificity:85.9-89%
Beck Depression Inventory-II Sensitivity:56-57%, Specificity:97-100%
Center for Epidemiologic Studies Deppression Scale Sensitivity:60%, Specificity:92%
Zung Self Rating Depression Scale Sensitivity:45-89%, Specificity:77-88%


References

  1. Sit D, Rothschild AJ, Wisner KL (May 2006). "A review of postpartum psychosis". J Womens Health (Larchmt). 15 (4): 352–68. doi:10.1089/jwh.2006.15.352. PMC 3109493. PMID 16724884.
  2. "Screening for Depression During and After Pregnancy - ACOG".

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