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Chapter 29 - Mood Disorders in Pregnancy and Postpartum Depression

from Section 5 - Psychiatric Disorders in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Victoria E. Canelos ,
Amira El-Messidi  and
Charlotte S. Hogan
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 21-year-old G1P1 with an uncomplicated pregnancy and vaginal delivery presents to your obstetrical assessment unit one week postpartum with concerns regarding the care of her newborn. She informs the nurse of difficulty with breastfeeding, which triggers a sense of worthlessness. The patient also complains of sleeplessness, even when the baby is asleep, and thereby is constantly exhausted. She shares with the nurse that she is ‘worried all the time about everything’ and finds herself crying randomly throughout the day for no apparent reason. The patient complains of intense ‘mood swings,’ which have led to frequent argumentation with her partner.

Keywords

Postpartum depression, differential diagnosisEdinburgh Postnatal Depression ScalePharmacologic treatment, typical and atypical antipsychoticsPostpartum psychosisRisk factorsLithium, gestational risks
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 387 - 396
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

ACOG Committee on Practice Bulletins – Obstetrics. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists No. 92, April 2008. Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol. 2008;111(4):1001–1020. Reaffirmed 2013.Google Scholar
American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Screening for perinatal depression. Committee Opinion. No. 757. Obstet Gynecol. 2018; 132:e208–e212.CrossRefGoogle Scholar
Becker, MA, Weinberger, TE, Chandy, A, et al. Mood disorders. Chapter 21 in: Berghella, V, ed., Maternal-Fetal Evidence Based Guidelines. Boca Raton, FL: CRC Press; 2017.Google Scholar
Hogan, CS, Freeman, MP. Adverse effects in the pharmacologic management of bipolar disorder during pregnancy. Psychiatr Clin North Am. 2016 Sep;39(3):465–475.CrossRefGoogle ScholarPubMed
Howard, LM, Megnin-Viggars, O, Symington, I, et al. Antenatal and postnatal mental health: summary of updated NICE guidance. BMJ. 2014 Dec 18;v349:g7394.CrossRefGoogle Scholar
Learman, LA. Screening for depression in pregnancy and the postpartum period. Clin Obstet Gynecol. 2018;61(3):525–532.Google Scholar
Molyneaux, E, Howard, LM, McGeown, HR, et al. Antidepressant treatment for postnatal depression. Cochrane Database Syst Rev. 2014;(9):CD002018.CrossRefGoogle Scholar
Pearlstein, T. Depression during pregnancy. Best Pract Res Clin Obstet Gynaecol. 2015;29(5):754–764.CrossRefGoogle ScholarPubMed
O’Connor, E, Senger, CA, Henninger, ML, et al. Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2019;321(6):588–601.CrossRefGoogle ScholarPubMed
Smith, B, Dubovsky, SL. Pharmacotherapy of mood disorders and psychosis in pre- and post-natal women. Expert Opin Pharmacother. 2017;18(16):1703–1719.CrossRefGoogle ScholarPubMed

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