Post-partum

Psychiatry
AL-Saleh, Yassin ,M. college of
medicine, KSU.
Objectives
To Identify the different types of
post-partum psychiatry .
To give an epidemiological data.
To determine the risk factors
associated with different types.
To review the clinical feature of
each type.
To learn how to manage each
disorder.
Introduction
The importance of post-partum
period.

Post-partum psychiatry :
1- Post-partum depression.
2- Post-partum psychosis.
3- Post-partum OCD.
4- Postpartum anxiety/panic disorder.
Post-partum depression.- 1
((definition
Postpartum depression is a major
depressive episode with an onset in
the first four weeks following
childbirth.
Postpartum depression Vs
postpartum blues (baby blue).
Baby blue last for two weeks after
delivery.
Why it is called baby blue?
Post-partum depression.- 1
((epidemiology
10-15% of new mothers develop
postpartum depression.
Only 10% seek for help.
CAUSES:
Unknown. (biological factor, genetic ,
hormonal, life stresses)
Post-partum depression.- 1
( (Risk factors
Personal history of depression
Family history of depression
Unplanned pregnancy
Poor support from partner
Single parent
Depression during pregnancy
Complications during pregnancy
Pre-term birth
Poor social support
Post-partum depression.- 1
((symptoms
Lack of interest or pleasure in
activities.
Lack of appetite or pleasure in
eating .
Sleep disruption .
Fatigue or lack of motivation.
Feelings of guilt or worthlessness .
Poor concentration .
Persistent anxiety ↑.
Thoughts of death or suicide ↓.
Post-partum depression.- 1
((differential diagnosis
puerperal psychosis.
postpartum
hypothyroidism.
anaemia.
1- Post-partum depression.
(management)
Multifactorial.
Reassurance.
Psychoeducation.
Psychotherapy.
pharmacologic treatment.
Acupuncture, herb, dietary
supplements, massage and
relaxation techniques.
Post-partum deperession.- 1
((management
Level of
Treatment
depression

Mild to moderate psychotherapy, cognitive therapy

Serotonin re-uptake inhibitors (Fluoxetine,

Sertraline, Paroxetine)
Moderate to
Tricyclic antidepressants (Imipramine,
severe
Nortriptyline, and others)
New generation antidepressants (Venlafaxine,
Buproprion, and others)
Combined psychotherapy and antidepressant
Mild to severe
medications

Severe depression Electroconvulsive therapy

Postpartum psychosis- 2
about 0. 1-0.2% of new mothers.
condition is defined as an atypical
psychosis which may begin within the
first six months of delivery.
 Presenting symptoms include severe
insomnia, agitation and restlessness,
hallucinations, paranoia and delusions
focused on the baby. Homicidal and
suicidal thought are not uncommon.
Consider as a medical emergency.
3-Postpartum obsessive
compulsive disorder
Condition characterized by many of
the typical symptoms of OCD,
however the obsessions and the
compulsion are more focused on
the baby and the patient's new role
and responsibilities of being a
mother.
Postpartum anxiety/panic-4
disorder
condition which characterized by
symptoms of intense anxiety or
panic and may involve many
somatic symptoms such:
cardiac palpitations, tachycardia,
tachypnea, dyspnea, hot or cold
flashes, chest pain, abdominal
pain, dizziness, tremor and feelings
of doom and helplessness.
Conclusion
Women should be followed during
post partum period, especially if
they have a history of depression
or depressive symptoms during
pregnancy.
Treatment should be multifactorial,
including consideration of
psychosocial as well as
pharmacologic options.
 Any
Question
?
Thank you