Perinatal Mental Health Quiz (March 2011)

Questions and answers by the lovely Scallywag

1. Sophie is 16 weeks’ pregnant and attends the Antenatal Clinic complaining of feeling anxious, irritable and crying easily. Her blood tests are fine and the pregnancy is progressing well. What is the likely diagnosis?
A. Antenatal Depression

2. Sophie doesn’t believe that this is a real illness. What percentage of women is this condition estimated to affect?
A. Around 10%

3. Laura has a history of Bipolar Disorder and takes Clozapine. At her booking appointment, she asks whether the drugs will harm her baby. What do you say?
A. Clozapine is not known to have any adverse effect on pregnancy, although caution is advised

4. Laura is still concerned about possible complications due to her medication. She asks if she should stop taking them. What do you suggest?
A. No. Laura shouldn’t stop taking her medication without first seeking the advice of her GP or Psychiatrist if she has one

5. Amy has a history of substance misuse. She is in early labour and admits that she has smoked cannabis regularly throughout her pregnancy, and had a joint a couple of hours ago to help ease the pain. She wants to know if she can have some Pethidine. Are there any dangers associated with giving Pethidine? What should Amy be warned about?
A. Although cannabis can increase the effects of Pethidine, there is no evidence that it is dangerous, so Pethidine can be safely given. Amy should be warned that she may feel particularly woozy or disorientated due to the effects of both drugs

6. After a short labour, Amy’s baby son is born. What problems may her son experience in childhood due to her cannabis use during pregnancy?
A. Slow physical growth, asthma, SIDS, learning difficulties, behavioural difficulties, eyesight problems, heart defects

7. Trish gave birth naturally three days ago to a baby girl. On a postnatal visit at her home, she reports feeling tearful, tired and emotional. What could possibly be wrong and what would you suggest to Trish?
A. “Baby Blues”. Reassure Trish that it’s normal around 3-5 days after birth. Recommend that she gets as much help as possible with the baby, and gets plenty of rest. This feeling will usually pass in a few days

8. Trish contacts you ten days later, claiming that she’s feeling worse and doesn’t think she can cope. She is constantly tearful and anxious and is finding it hard to get out of bed. What is a possible diagnosis, and approximately what percentage of women experience this problem?
A. Postnatal Depression. Between 10-15%

9. Joan gave birth to twins three weeks ago and she complains to her Health Visitor of feeling extremely tired and emotional. What is the name of the test that her Health Visitor asks her to complete?
A. The Edinburgh Postnatal Depression Scale

10. A few days later, Joan’s husband calls you in distress. Joan is suffering from delusions that one of her twins is possessed by the devil, and she has spoken about drowning him in the bath. What could be the diagnosis? What professionals or agencies may be involved in her care?
A. Puerperal Psychosis. GP, Community Psychiatric Nurse, Community Mental Health Team, Health Visitor, Social Services

Bonus. What are the known risk factors for Postnatal Illness?
A. Hormonal imbalance, history of mental illness / depression, fertility problems, twins / multiple births, previous miscarriage / stillbirth, unwanted pregnancy, single parent, young mother, traumatic birth, bereavement, domestic abuse, financial worries, relationship problems, housing problems