Perinatal Mental Health

1. The FY1 who is in charge of the labour ward called you to review a patient who gave birth a few days earlier seems confused and delusional. They are worried that she may have postpartum psychosis. Upon reviewing the patient’s notes, you became aware that the patient does not have any risk factors for postpartum psychosis. What percentage of patients, who develop postpartum psychosis will have no history to classify them at high risk?

2. An elderly primigravida presents to you with confusion and delusion in the postpartum phase. You suspect she might be having postpartum psychosis. When is the typical presentation of postpartum psychosis?

3. You are reviewing a patient in the antenatal clinic; she was taking lithium for bipolar disorder but stopped when she found out she was pregnant. She has no history of postpartum psychosis. What is the risk of patients with bipolar disorder developing postpartum psychosis?

4. Mrs Anora, 24-year-old, primiparous woman, delivered her first baby 5 days back, is extremely tearful. She has anxiety about whether she can take care of the baby well. Husband says she is crying for small things. She is taking care of the baby well. What is your diagnosis?

5. Mrs Bainy, primiparous, delivered 7days ago, has an intense feeling of hopelessness, worthlessness.  She is restless. She is extremely anxious and has panic attacks sometimes she has thoughts of harming herself or baby. She has recurrent thoughts of death or suicide. What is your diagnosis?

6. You are reviewing a patient in the antenatal clinic. She is on Lithium for bipolar disorder. Both her sisters & mother has a history of postpartum psychosis. What is her risk of developing postpartum psychosis?

7. You are reviewing a patient in the antenatal clinic. She is on Lithium for bipolar disorder. Both her sisters & mother has a history of postpartum psychosis. Genetic inheritance is linked to the possible location of susceptibility gene on which chromosome?

8. According to NICE, women with perinatal mental health should be admitted to Mother & baby units for their care. Which women can be offered this facility?