PMH-C
Perinatal
Period
-
ANS
conception
through
the
first
year
after
giving
birth.
Antenatal
-
ANS
Term
meaning
"During
Pregnancy"
Postpartum/Postnatal
-
ANS
The
first
year
after
giving
birth
Disorders
-
ANS
Get
in
the
way
of
daily
functioning.
Every
year,
how
many
infants
are
born
to
mothers
who
are
depressed?
-
ANS
400,000,
making
perinatal
depression
the
most
under
diagnosed
obstetric
complication
in
America.
What
is
the
prevalence
of
PMAD's
for
women?
-
ANS
1
out
of
5-7
women.
What
is
the
prevalence
of
PMAD's
for
men?
-
ANS
1
out
of
10
men.
What
is
the
cost
of
untreated
PMAD's?
-
ANS
$14.2
Billion
annually
How
many
pregnancies
are
unplanned?
-
ANS
~50%
What
are
the
PMAD
etiologies
(causes)?
-
ANS
Biological
Sensitivity
to
hormonal
changes
(sleep
deprivation),
Vulnerability
(such
as
genetic
disposition),
psychological
(relationship
with
own
mother,
ambivalence
to
parenthood,
self-image/perfectionism),
Social/environmental
(hx
of
trauma,
poor
social
support,
institutional
racism).
In
what
ways
does
culture
influence
whether
PMAD's
are
recognized?
-
ANS
There
are
diverse
ways
that
mothers
conceptualize
and
explain
their
symptoms
culturally.
They
may
not
feel
they
are
safe
to
express
their
symptoms.
May
be
expressed
in
somatic
(eg.
stomach
pains
or
appetite
changes)
or
affective
ways
(moods,
feelings).
Why
is
there
variability
in
prevalence
rates
of
PMAD's?
-
ANS
Cultural
context,
screening
inventories,
cutoffs
used
on
objective
measures,
timing
of
screening
and
onset
of
symptoms,
relationship
between
the
subject
and
the
researcher.
What
is
the
strongest
predictor
for
paternal
(fathers)
depression.
-
ANS
Maternal
depression
When
do
father's
depressive
symptoms
spike?
-
ANS
Between
3-6
months
postpartum
What
is
"masked"
male
depression?
-
ANS
Rather
than
sadnes,
men
may
increase
substance
use,
be
more
irritable,
aggressive
or
hostile.
May
"check
out",
self
isolate. Possible
factors
for
partner
depression.
-
ANS
Feeling
burdened/trapped,
financial
burdens,
feeling
left
out,
missing
sexual
relationship,
sleep
deprivation,
isolation
and
loneliness,
poor
social
support
network.
Is
this
pregnancy
emotions
or
depression?
Mood
is
labile
(frequently
changes),
teary.
-
ANS
Pregnancy
Is
this
pregnancy
emotions
or
depression?
Mood
is
gloom,
irritable,
agitation,
or
rage
-
ANS
Depression
Is
this
pregnancy
emotions
or
depression?
Self
esteem
is
low.
Guilt.
-
ANS
Depression
(In
pregnancy,
self
esteem
is
unchanged)
Is
this
pregnancy
emotions
or
depression?
Difficulty
initiating
and/or
sustaining
sleep.
-
ANS
Depression
(Having
to
urinate
frequently
or
having
heartburn
are
symptoms
of
pregnancy).
Is
this
pregnancy
or
depression?
Fatigue,
rest
does
not
restore.
-
ANS
Depression
(May
be
tired
during
pregnancy
but
rest
restores.)
Is
this
pregnancy
or
depression?
Anhedonia
-
ANS
Depression.
Anhedonia
is
the
inability
to
feel
pleasure.
Is
this
pregnancy
or
depression?
Dysregulation
of
appetite
-
ANS
Depression
How
many
new
mothers
are
universally
affected
by
the
Baby
Blues?
-
ANS
60-80%
Hormone
fluctuation
at
the
time
of
birth
and
acute
sleep
deprivation
can
lead
to
what
common
situation
or
non-disorder?
-
ANS
baby
blues
How
long
do
the
baby
blues
last?
-
ANS
2
days
to
2
weeks
after
birth
When
do
baby
blues
typically
peak?
-
ANS
on
day
3-5
after
delivery.
What
are
the
symptoms
of
baby
blues?
-
ANS
tearfulness,
lability,
reactivity,
and
exhaustion.
Unrelated
to
stress
or
prior
psychiatric
hx.
When
making
a
determination
between
baby
blues
and
major
depression,
what
should
be
considered?
-
ANS
severity/intensity,
timing/onset,
duration/chronicity
Under
the
DSM-5,
what
code
can
we
use
for
postpartum
depression?
-
ANS
Major
Unipolar
Depression
(with
peripartum
onset) For
the
DSM-5
code
of
Major
Unipolar
Depression
(with
peripartum
onset),
5
or
more
symptoms
must
be
present
with
the
same
2-week
period:
-
ANS
Depressed
mood
most
of
the
day
nearly
every
day.
Loss
of
interest,
joy
or
pleasure
(anhedonia).
Significant
wt
or
appetite
changes.
Sleep
disturbances.
Psychomotor
agitation/retardation.
Fatigue/loss
of
energy.
Poor
concentration/focus/indecisiveness.
Feelings
of
worthlessness.
Excessive/inappropriate
guilt.
Recurrent
thoughts
of
death/suicidal
thoughts.
Signs
of
Generalized
Anxiety
Disorder
-
ANS
Excessive
anxiety/worry.
Difficulty
controlling
one's
worry.
Agitation/Irritability.
Restlessness.
Poor
concentration.
Easily
fatigues/sleep
disturbances.
Increased
somatic
symptoms.
What
is
the
prevalence
for
prenatal
anxiety?
-
ANS
15.8%
What
is
the
prevalence
estimates
for
postpartum
anxiety
symptoms?
-
ANS
8%-20%
Panic
Disorder
symptoms?
-
ANS
Episodes
of
intense
fear
or
discomfort
reaching
a
peak
within
minutes.
SOB,
chest
pain,
dizziness,
feeling
of
choking.
Hot/Cold
flashes.
Restlessness,
rapid
heart
beat,
numbness/tingling
sensations.
Excessive
worry/fear.
Feeling
as
though
"going
crazy",
losing
control,
or
having
a
future
attack.
Often
no
identifiable
trigger.
What
are
the
3
greatest
fears
of
a
panic
disorder?
-
ANS
Fear
of
dying,
fear
of
losing
control,
fear
of
going
crazy.
What
term
describes
recurrent
and
persistent
thoughts,
or
impulses
that
are
intrusive
and
unwanted
and
cause
marked
anxiety
or
distress?
Individuals
tend
to
attempt
to
try
to
ignore
or
suppress
the
thoughts,
urges,
or
images
or
to
neutralize
them
with
some
other
thought
or
action.
-
ANS
Obsessions
What
term
describes
repetitive
behaviors
that
the
individual
feels
driven
to
perform
in
response
to
the
obsession.
Behaviors
or
mental
acts
are
aimed
at
preventing
or
reducing
anxiety
or
distress.
-
ANS
Compulsions
Perinatal
women
are
at
a
_____
greater
risk
for
OCD
onset
than
the
general
population.
-
ANS
1.5-2X
___%
had
OCD
onset
in
the
perinatal
period.
-
ANS
32%
Severe
OCD
remains
largely
unchanged
across___
-
ANS
pregnancy
and
the
postpartum
period.
65%
have
co-morbid
depression
along
with
what?
-
ANS
Perinatal
OCD
ego-dystonic
thoughts
-
ANS
Thoughts
or
impulses
and
behaviors
that
are
felt
to
be
distressing,
unacceptable,
or
inconsistent
with
one's
self
concept.
