SlideShare a Scribd company logo
Psychiatric Morbidity And Pregnancy Dr J Romain
Epidemiology 15-30% new mothers suffer from mild depression 10% new mothers likely to suffer with major depressive illness Between 1/3- ½ will have a severe depressive illness 2% women see a psychiatrist within first year after delivery 4 in 1000 admitted to psychiatric hospital, of which 80% will be suffering from their first ever psychiatric illness
Majority of women suffer mild depressive illness Little evidence that this is more common than in the general population Risk of developing severe mental illness- puerperal psychosis or severe depression is increased by 16-fold, particularly in the first 3 months post partum
Importance of Psychiatry Substantial Morbidity- leading overall cause of maternal mortality in CEMACH’s ‘Why Mothers Die’ 2000-2002 Effective treatment Adverse consequences Predict risk Regular medical contact Prevention
Risk Factors for Mild Depression Tend to be psychosocial Single (unsupported) Young Short Interval Early deprivation Chronic life difficulties Society adversity trend Past psychiatric hx Prior social services involvement Life Events
Risk Factors for Serious Mental Illness Often biological Primiparity (especially if had a c-section) Past psychiatric history (1 in 3-5 risk) Family psychiatric history (1 in 3 risk)
Baby ‘Blues’ Majority of women experience some alteration in their mental state between days 3-10. Progesterone dropping. Commonly day 5 Low, tearful and labile mood, irritability, insomnia. Bouts of despair and catastrophizing Usually only lasts 48hrs Responds to kindness and reassurance
Mild Postnatal Depression At least 7% women meet the criteria Vulnerable ‘at risk’ women Insidious onset in 1 st  week, present 3 months – year via health visitor Tearful, difficulty coping, unsatisfied with motherhood, anxiety, phobia’s, loneliness and isolation Treatment with counselling (6 weekly) and social support
Severe Major Postnatal Depresssion Affects between 3-5% of women Onset in first 2 weeks but can be up to 12 weeks, peak between 2-4, 10-14 Biological symptoms; early morning wakening, impaired appetite, concentration and interests, anhedonia Mood profoundly low, guilt and incompetent Treatment; antidepressants (SSRI’s, tricyclics) need to be continued for 6 months after recovery. Counselling. Good prognosis Risk of relapse; 1 in 2 for future pregnancies outside childbirth risk of depression is low
Puerperal Psychosis Abrupt onset 80%  3-14 days, rapidly deteriorates Likened to manic-depressive or bipolar affective disorder Restless agitation, perplexity, confusion, fear and suspicion, delusions about themselves and their baby Many experience first-rank schizophrenic hallucinations and delusions Treatment; urgent referral to psychiatrist +/- admission to mother and baby unit. If severe; ECT. Recovery 2-6wks, cont. meds for 6 months, Risk of 1 in 2 during subsequent pregnancies. Advised to delay 2 yrs for next baby
Adverse Sequelae of PND Immediate- physical morbidity   suicide/infanticide   prolonged psychiatric morbidit   social bond mother-baby   emotional development Later- social-cognitive affects child   psychiatric morbidity child   marital breakdown
Prevention High risk patients (previous psychiatric history, family history) picked up early in pregnancy Monitored closely; seen in hospital clinics and by psychiatrist if necessary- prophylactic meds Long term follow up postnatally
Thankyou!

More Related Content

What's hot

Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
Uyanga Bayandalai, BS, LADC
 
Perinatal psychiatry
Perinatal psychiatryPerinatal psychiatry
Perinatal psychiatry
Dr. Kamal Ghimire
 
Depression by dr ajay nihalani
Depression by dr ajay nihalaniDepression by dr ajay nihalani
Depression by dr ajay nihalani
Dr Ajay Nihalani
 
Maternal and Child Mental Health_Senefeld
Maternal and Child Mental Health_Senefeld Maternal and Child Mental Health_Senefeld
Maternal and Child Mental Health_Senefeld
CORE Group
 
Post partum psychiatry
Post partum psychiatryPost partum psychiatry
Post partum psychiatry
Yassin Alsaleh
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
fitango
 
Talking psychiatry...Psychiatric disorders in pregnancy
Talking psychiatry...Psychiatric disorders in pregnancyTalking psychiatry...Psychiatric disorders in pregnancy
Talking psychiatry...Psychiatric disorders in pregnancy
Professor Yasser Metwally
 
Mood Disorders in Pregnancy and the Postpartum
Mood Disorders in Pregnancy and the PostpartumMood Disorders in Pregnancy and the Postpartum
Mood Disorders in Pregnancy and the Postpartum
Children’s Trust of South Carolina
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
jozuna
 
Mental health disorders in pregnancy
Mental health disorders in pregnancyMental health disorders in pregnancy
Mental health disorders in pregnancy
Sami Shawer
 
Mental health problem in pregnancy by sarah mohamed aboelsoud
Mental health problem in pregnancy by sarah mohamed aboelsoudMental health problem in pregnancy by sarah mohamed aboelsoud
Mental health problem in pregnancy by sarah mohamed aboelsoud
SarahAboelsoud1
 
Psychiatric aspect of obstetrics and gynecology
Psychiatric aspect of obstetrics and gynecologyPsychiatric aspect of obstetrics and gynecology
Psychiatric aspect of obstetrics and gynecology
Kavindya Fernando
 
Postpartum Depression
Postpartum DepressionPostpartum Depression
Postpartum Depression
adinaharlan
 
Postpartum psychiatric disorder
Postpartum psychiatric disorderPostpartum psychiatric disorder
Postpartum psychiatric disorder
Nur Liyana Malek
 
Women’s Mental Health & Perinatal Psychiatry
Women’s Mental Health & Perinatal PsychiatryWomen’s Mental Health & Perinatal Psychiatry
Women’s Mental Health & Perinatal Psychiatry
Dr. Umi Adzlin Silim
 
Summary of psychiatric disorders during pregnancy & lactation
Summary of psychiatric disorders during pregnancy & lactationSummary of psychiatric disorders during pregnancy & lactation
Summary of psychiatric disorders during pregnancy & lactation
Hosam Hassan
 
Perinatal mood disorder
Perinatal mood disorderPerinatal mood disorder
Perinatal mood disorder
Dan Hillier
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
Reham Elrefaay
 
Women and mental health
Women and mental healthWomen and mental health
Women and mental health
RuppaMercy
 
Postpartum Depression Research Paper
Postpartum Depression Research PaperPostpartum Depression Research Paper
Postpartum Depression Research Paper
Kristina Hyland
 

What's hot (20)

Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
 
Perinatal psychiatry
Perinatal psychiatryPerinatal psychiatry
Perinatal psychiatry
 
Depression by dr ajay nihalani
Depression by dr ajay nihalaniDepression by dr ajay nihalani
Depression by dr ajay nihalani
 
Maternal and Child Mental Health_Senefeld
Maternal and Child Mental Health_Senefeld Maternal and Child Mental Health_Senefeld
Maternal and Child Mental Health_Senefeld
 
Post partum psychiatry
Post partum psychiatryPost partum psychiatry
Post partum psychiatry
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
 
Talking psychiatry...Psychiatric disorders in pregnancy
Talking psychiatry...Psychiatric disorders in pregnancyTalking psychiatry...Psychiatric disorders in pregnancy
Talking psychiatry...Psychiatric disorders in pregnancy
 
Mood Disorders in Pregnancy and the Postpartum
Mood Disorders in Pregnancy and the PostpartumMood Disorders in Pregnancy and the Postpartum
Mood Disorders in Pregnancy and the Postpartum
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
 
Mental health disorders in pregnancy
Mental health disorders in pregnancyMental health disorders in pregnancy
Mental health disorders in pregnancy
 
Mental health problem in pregnancy by sarah mohamed aboelsoud
Mental health problem in pregnancy by sarah mohamed aboelsoudMental health problem in pregnancy by sarah mohamed aboelsoud
Mental health problem in pregnancy by sarah mohamed aboelsoud
 
Psychiatric aspect of obstetrics and gynecology
Psychiatric aspect of obstetrics and gynecologyPsychiatric aspect of obstetrics and gynecology
Psychiatric aspect of obstetrics and gynecology
 
Postpartum Depression
Postpartum DepressionPostpartum Depression
Postpartum Depression
 
Postpartum psychiatric disorder
Postpartum psychiatric disorderPostpartum psychiatric disorder
Postpartum psychiatric disorder
 
Women’s Mental Health & Perinatal Psychiatry
Women’s Mental Health & Perinatal PsychiatryWomen’s Mental Health & Perinatal Psychiatry
Women’s Mental Health & Perinatal Psychiatry
 
Summary of psychiatric disorders during pregnancy & lactation
Summary of psychiatric disorders during pregnancy & lactationSummary of psychiatric disorders during pregnancy & lactation
Summary of psychiatric disorders during pregnancy & lactation
 
Perinatal mood disorder
Perinatal mood disorderPerinatal mood disorder
Perinatal mood disorder
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
 
Women and mental health
Women and mental healthWomen and mental health
Women and mental health
 
Postpartum Depression Research Paper
Postpartum Depression Research PaperPostpartum Depression Research Paper
Postpartum Depression Research Paper
 

Similar to Psychiatric morbidity and pregnancy

POSTPARTUM PSYCHIATRIC DISORDERS.pptx
POSTPARTUM PSYCHIATRIC DISORDERS.pptxPOSTPARTUM PSYCHIATRIC DISORDERS.pptx
POSTPARTUM PSYCHIATRIC DISORDERS.pptx
ssusere95ebc
 
PostPartum PSYCHIATRIC DISORDERS-OT
PostPartum PSYCHIATRIC DISORDERS-OTPostPartum PSYCHIATRIC DISORDERS-OT
PostPartum PSYCHIATRIC DISORDERS-OT
Raviteja Innamuri
 
Factors to mental illness
Factors to mental illnessFactors to mental illness
Factors to mental illness
Emmanuel Sevor
 
Psychological complications.pptx
Psychological complications.pptxPsychological complications.pptx
Psychological complications.pptx
AnzuBista1
 
PPD.pptx
PPD.pptxPPD.pptx
PPD.pptx
Fahmida Swati
 
Mental illnes in pregnancy
Mental illnes in pregnancyMental illnes in pregnancy
Mental illnes in pregnancy
DR MUKESH SAH
 
More than baby blues_Senefeld, Reider, Schooley_10.13.11
More than baby blues_Senefeld, Reider, Schooley_10.13.11More than baby blues_Senefeld, Reider, Schooley_10.13.11
More than baby blues_Senefeld, Reider, Schooley_10.13.11
CORE Group
 
PPd presentation PCA NJ conference
PPd presentation PCA NJ conferencePPd presentation PCA NJ conference
PPd presentation PCA NJ conference
Gateway Northwest Maternal & Child Health Network
 
Pregnancy and puerperium
Pregnancy and puerperiumPregnancy and puerperium
Pregnancy and puerperium
nitinnin
 
women_2011b.PPT women mental health and education
women_2011b.PPT women mental health and educationwomen_2011b.PPT women mental health and education
women_2011b.PPT women mental health and education
jayvee73
 
Psychological disorders during puerperium
Psychological disorders during puerperiumPsychological disorders during puerperium
Psychological disorders during puerperium
jagadeeswari jayaseelan
 
Psychaitric disorders in women-prof. fareed minhas
Psychaitric disorders in women-prof. fareed minhasPsychaitric disorders in women-prof. fareed minhas
Psychaitric disorders in women-prof. fareed minhas
Rawalpindi Medical College
 
postpartumdepression is a ver y common disorders-170424094316.pdf
postpartumdepression is a ver y common disorders-170424094316.pdfpostpartumdepression is a ver y common disorders-170424094316.pdf
postpartumdepression is a ver y common disorders-170424094316.pdf
DivyaThomas45
 
39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx
39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx
39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx
AURELIATEMBA
 
Major depression
Major depressionMajor depression
Major depression
Reynel Dan
 
Postpartum Mood and Anxiety Disorders
Postpartum Mood and Anxiety DisordersPostpartum Mood and Anxiety Disorders
Postpartum Mood and Anxiety Disorders
Melissa Timpson
 
Psychiatry emergency in children
Psychiatry emergency in childrenPsychiatry emergency in children
Psychiatry emergency in children
syahirahrazak92
 
Depression In Women
Depression In  WomenDepression In  Women
Depression In Women
Hassan Tarig
 
Psychiatric disorders during pregnancy
Psychiatric disorders during pregnancyPsychiatric disorders during pregnancy
Psychiatric disorders during pregnancy
Ahmed Elbohoty
 
Puerperal mental disorder
Puerperal mental disorderPuerperal mental disorder
Puerperal mental disorder
Anas Perumanna
 

Similar to Psychiatric morbidity and pregnancy (20)

POSTPARTUM PSYCHIATRIC DISORDERS.pptx
POSTPARTUM PSYCHIATRIC DISORDERS.pptxPOSTPARTUM PSYCHIATRIC DISORDERS.pptx
POSTPARTUM PSYCHIATRIC DISORDERS.pptx
 
PostPartum PSYCHIATRIC DISORDERS-OT
PostPartum PSYCHIATRIC DISORDERS-OTPostPartum PSYCHIATRIC DISORDERS-OT
PostPartum PSYCHIATRIC DISORDERS-OT
 
Factors to mental illness
Factors to mental illnessFactors to mental illness
Factors to mental illness
 
Psychological complications.pptx
Psychological complications.pptxPsychological complications.pptx
Psychological complications.pptx
 
PPD.pptx
PPD.pptxPPD.pptx
PPD.pptx
 
Mental illnes in pregnancy
Mental illnes in pregnancyMental illnes in pregnancy
Mental illnes in pregnancy
 
More than baby blues_Senefeld, Reider, Schooley_10.13.11
More than baby blues_Senefeld, Reider, Schooley_10.13.11More than baby blues_Senefeld, Reider, Schooley_10.13.11
More than baby blues_Senefeld, Reider, Schooley_10.13.11
 
PPd presentation PCA NJ conference
PPd presentation PCA NJ conferencePPd presentation PCA NJ conference
PPd presentation PCA NJ conference
 
Pregnancy and puerperium
Pregnancy and puerperiumPregnancy and puerperium
Pregnancy and puerperium
 
women_2011b.PPT women mental health and education
women_2011b.PPT women mental health and educationwomen_2011b.PPT women mental health and education
women_2011b.PPT women mental health and education
 
Psychological disorders during puerperium
Psychological disorders during puerperiumPsychological disorders during puerperium
Psychological disorders during puerperium
 
Psychaitric disorders in women-prof. fareed minhas
Psychaitric disorders in women-prof. fareed minhasPsychaitric disorders in women-prof. fareed minhas
Psychaitric disorders in women-prof. fareed minhas
 
postpartumdepression is a ver y common disorders-170424094316.pdf
postpartumdepression is a ver y common disorders-170424094316.pdfpostpartumdepression is a ver y common disorders-170424094316.pdf
postpartumdepression is a ver y common disorders-170424094316.pdf
 
39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx
39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx
39. PERINATAL MENTAL HEALTH DISORDERS-LUCY KISAKA.pptx
 
Major depression
Major depressionMajor depression
Major depression
 
Postpartum Mood and Anxiety Disorders
Postpartum Mood and Anxiety DisordersPostpartum Mood and Anxiety Disorders
Postpartum Mood and Anxiety Disorders
 
Psychiatry emergency in children
Psychiatry emergency in childrenPsychiatry emergency in children
Psychiatry emergency in children
 
Depression In Women
Depression In  WomenDepression In  Women
Depression In Women
 
Psychiatric disorders during pregnancy
Psychiatric disorders during pregnancyPsychiatric disorders during pregnancy
Psychiatric disorders during pregnancy
 
Puerperal mental disorder
Puerperal mental disorderPuerperal mental disorder
Puerperal mental disorder
 

More from Nick Harvey

Premenstrual syndrome
Premenstrual syndromePremenstrual syndrome
Premenstrual syndrome
Nick Harvey
 
Schizo obessive disorder
Schizo obessive disorderSchizo obessive disorder
Schizo obessive disorder
Nick Harvey
 
Journal club psych
Journal club psychJournal club psych
Journal club psych
Nick Harvey
 
Hrt journal club
Hrt journal clubHrt journal club
Hrt journal club
Nick Harvey
 
Benign lesions of the cervix, vagina and vulva
Benign lesions of the cervix, vagina and vulvaBenign lesions of the cervix, vagina and vulva
Benign lesions of the cervix, vagina and vulva
Nick Harvey
 
Menorrhagia
MenorrhagiaMenorrhagia
Menorrhagia
Nick Harvey
 
The principles of antenatal care
The principles of antenatal careThe principles of antenatal care
The principles of antenatal care
Nick Harvey
 
Cranial Nerves
Cranial NervesCranial Nerves
Cranial Nerves
Nick Harvey
 
The Eye And Ear
The Eye And EarThe Eye And Ear
The Eye And Ear
Nick Harvey
 
A Brief History Of Surgery
A Brief History Of SurgeryA Brief History Of Surgery
A Brief History Of Surgery
Nick Harvey
 
General Surgery Revision
General Surgery RevisionGeneral Surgery Revision
General Surgery Revision
Nick Harvey
 

More from Nick Harvey (11)

Premenstrual syndrome
Premenstrual syndromePremenstrual syndrome
Premenstrual syndrome
 
Schizo obessive disorder
Schizo obessive disorderSchizo obessive disorder
Schizo obessive disorder
 
Journal club psych
Journal club psychJournal club psych
Journal club psych
 
Hrt journal club
Hrt journal clubHrt journal club
Hrt journal club
 
Benign lesions of the cervix, vagina and vulva
Benign lesions of the cervix, vagina and vulvaBenign lesions of the cervix, vagina and vulva
Benign lesions of the cervix, vagina and vulva
 
Menorrhagia
MenorrhagiaMenorrhagia
Menorrhagia
 
The principles of antenatal care
The principles of antenatal careThe principles of antenatal care
The principles of antenatal care
 
Cranial Nerves
Cranial NervesCranial Nerves
Cranial Nerves
 
The Eye And Ear
The Eye And EarThe Eye And Ear
The Eye And Ear
 
A Brief History Of Surgery
A Brief History Of SurgeryA Brief History Of Surgery
A Brief History Of Surgery
 
General Surgery Revision
General Surgery RevisionGeneral Surgery Revision
General Surgery Revision
 

Recently uploaded

JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan PatroJULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
Kanhu Charan
 
Prostatitis Severity- How to Determine if You Have Mild Symptoms.pptx
Prostatitis Severity- How to Determine if You Have Mild Symptoms.pptxProstatitis Severity- How to Determine if You Have Mild Symptoms.pptx
Prostatitis Severity- How to Determine if You Have Mild Symptoms.pptx
AmandaChou9
 
Pharmacological Management of Hypertension: New Drugs and Mechanisms
Pharmacological Management of Hypertension: New Drugs and MechanismsPharmacological Management of Hypertension: New Drugs and Mechanisms
Pharmacological Management of Hypertension: New Drugs and Mechanisms
Medwin Publishers
 
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptxselllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
Joebest8
 
Therapeutic modalities ( Psychopharmacology).pptx
Therapeutic modalities ( Psychopharmacology).pptxTherapeutic modalities ( Psychopharmacology).pptx
Therapeutic modalities ( Psychopharmacology).pptx
vidyariner7
 
Approach to Head Injuiry, Intracranial Pressure Measurement and Management.pptx
Approach to Head Injuiry, Intracranial Pressure Measurement and Management.pptxApproach to Head Injuiry, Intracranial Pressure Measurement and Management.pptx
Approach to Head Injuiry, Intracranial Pressure Measurement and Management.pptx
Bipul Thakur
 
Interpretation of ECG - Cardiac Arrhythmias
Interpretation of ECG - Cardiac ArrhythmiasInterpretation of ECG - Cardiac Arrhythmias
Interpretation of ECG - Cardiac Arrhythmias
MedicoseAcademics
 
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptxCare and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Dr. Jagroop Singh
 
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
DRPREETHIJAMESP
 
Respiratory system at glance- Neonatology
Respiratory system at glance- NeonatologyRespiratory system at glance- Neonatology
Respiratory system at glance- Neonatology
Dr. Habibur Rahim
 
Medical oncologic management of Colorectal cancer-1-1.pptx
Medical oncologic management of Colorectal cancer-1-1.pptxMedical oncologic management of Colorectal cancer-1-1.pptx
Medical oncologic management of Colorectal cancer-1-1.pptx
robel26
 
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptxNosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
jeearu
 
Hand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing BookHand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing Book
BP KOIRALA INSTITUTE OF HELATH SCIENCS,, NEPAL
 
Text book of comprehensive Medical Surgical Nursing
Text book of comprehensive Medical Surgical NursingText book of comprehensive Medical Surgical Nursing
Text book of comprehensive Medical Surgical Nursing
BP KOIRALA INSTITUTE OF HELATH SCIENCS,, NEPAL
 
Building a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical TeamBuilding a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical Team
bkling
 
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxPOTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
souravpaul769171
 
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdfNUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
MatsikoAlex
 
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in DohaAbortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
maishakhanam230
 
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptxExploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
FFragrant
 
vaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Alivaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Ali
RewAs ALI
 

Recently uploaded (20)

JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan PatroJULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
 
Prostatitis Severity- How to Determine if You Have Mild Symptoms.pptx
Prostatitis Severity- How to Determine if You Have Mild Symptoms.pptxProstatitis Severity- How to Determine if You Have Mild Symptoms.pptx
Prostatitis Severity- How to Determine if You Have Mild Symptoms.pptx
 
Pharmacological Management of Hypertension: New Drugs and Mechanisms
Pharmacological Management of Hypertension: New Drugs and MechanismsPharmacological Management of Hypertension: New Drugs and Mechanisms
Pharmacological Management of Hypertension: New Drugs and Mechanisms
 
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptxselllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
 
Therapeutic modalities ( Psychopharmacology).pptx
Therapeutic modalities ( Psychopharmacology).pptxTherapeutic modalities ( Psychopharmacology).pptx
Therapeutic modalities ( Psychopharmacology).pptx
 
Approach to Head Injuiry, Intracranial Pressure Measurement and Management.pptx
Approach to Head Injuiry, Intracranial Pressure Measurement and Management.pptxApproach to Head Injuiry, Intracranial Pressure Measurement and Management.pptx
Approach to Head Injuiry, Intracranial Pressure Measurement and Management.pptx
 
Interpretation of ECG - Cardiac Arrhythmias
Interpretation of ECG - Cardiac ArrhythmiasInterpretation of ECG - Cardiac Arrhythmias
Interpretation of ECG - Cardiac Arrhythmias
 
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptxCare and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
 
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
 
Respiratory system at glance- Neonatology
Respiratory system at glance- NeonatologyRespiratory system at glance- Neonatology
Respiratory system at glance- Neonatology
 
Medical oncologic management of Colorectal cancer-1-1.pptx
Medical oncologic management of Colorectal cancer-1-1.pptxMedical oncologic management of Colorectal cancer-1-1.pptx
Medical oncologic management of Colorectal cancer-1-1.pptx
 
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptxNosodes in Homeopathy, Understanding the Basis and Applications.pptx
Nosodes in Homeopathy, Understanding the Basis and Applications.pptx
 
Hand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing BookHand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing Book
 
Text book of comprehensive Medical Surgical Nursing
Text book of comprehensive Medical Surgical NursingText book of comprehensive Medical Surgical Nursing
Text book of comprehensive Medical Surgical Nursing
 
Building a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical TeamBuilding a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical Team
 
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxPOTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
 
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdfNUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
 
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in DohaAbortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
Abortion pills for sale in Qatar(+919707208804)Buy Cytotec tablet in Doha
 
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptxExploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
 
vaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Alivaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Ali
 

Psychiatric morbidity and pregnancy

  • 1. Psychiatric Morbidity And Pregnancy Dr J Romain
  • 2. Epidemiology 15-30% new mothers suffer from mild depression 10% new mothers likely to suffer with major depressive illness Between 1/3- ½ will have a severe depressive illness 2% women see a psychiatrist within first year after delivery 4 in 1000 admitted to psychiatric hospital, of which 80% will be suffering from their first ever psychiatric illness
  • 3. Majority of women suffer mild depressive illness Little evidence that this is more common than in the general population Risk of developing severe mental illness- puerperal psychosis or severe depression is increased by 16-fold, particularly in the first 3 months post partum
  • 4. Importance of Psychiatry Substantial Morbidity- leading overall cause of maternal mortality in CEMACH’s ‘Why Mothers Die’ 2000-2002 Effective treatment Adverse consequences Predict risk Regular medical contact Prevention
  • 5. Risk Factors for Mild Depression Tend to be psychosocial Single (unsupported) Young Short Interval Early deprivation Chronic life difficulties Society adversity trend Past psychiatric hx Prior social services involvement Life Events
  • 6. Risk Factors for Serious Mental Illness Often biological Primiparity (especially if had a c-section) Past psychiatric history (1 in 3-5 risk) Family psychiatric history (1 in 3 risk)
  • 7. Baby ‘Blues’ Majority of women experience some alteration in their mental state between days 3-10. Progesterone dropping. Commonly day 5 Low, tearful and labile mood, irritability, insomnia. Bouts of despair and catastrophizing Usually only lasts 48hrs Responds to kindness and reassurance
  • 8. Mild Postnatal Depression At least 7% women meet the criteria Vulnerable ‘at risk’ women Insidious onset in 1 st week, present 3 months – year via health visitor Tearful, difficulty coping, unsatisfied with motherhood, anxiety, phobia’s, loneliness and isolation Treatment with counselling (6 weekly) and social support
  • 9. Severe Major Postnatal Depresssion Affects between 3-5% of women Onset in first 2 weeks but can be up to 12 weeks, peak between 2-4, 10-14 Biological symptoms; early morning wakening, impaired appetite, concentration and interests, anhedonia Mood profoundly low, guilt and incompetent Treatment; antidepressants (SSRI’s, tricyclics) need to be continued for 6 months after recovery. Counselling. Good prognosis Risk of relapse; 1 in 2 for future pregnancies outside childbirth risk of depression is low
  • 10. Puerperal Psychosis Abrupt onset 80% 3-14 days, rapidly deteriorates Likened to manic-depressive or bipolar affective disorder Restless agitation, perplexity, confusion, fear and suspicion, delusions about themselves and their baby Many experience first-rank schizophrenic hallucinations and delusions Treatment; urgent referral to psychiatrist +/- admission to mother and baby unit. If severe; ECT. Recovery 2-6wks, cont. meds for 6 months, Risk of 1 in 2 during subsequent pregnancies. Advised to delay 2 yrs for next baby
  • 11. Adverse Sequelae of PND Immediate- physical morbidity suicide/infanticide prolonged psychiatric morbidit social bond mother-baby emotional development Later- social-cognitive affects child psychiatric morbidity child marital breakdown
  • 12. Prevention High risk patients (previous psychiatric history, family history) picked up early in pregnancy Monitored closely; seen in hospital clinics and by psychiatrist if necessary- prophylactic meds Long term follow up postnatally