PMH-C Anxiety Disorders in Pregnancy 5

Question 1

Which statement about the Edinburgh Postnatal Depression Scale (EPDS) use in pregnancy is most accurate?

Accepted Answer

It has been validated for antenatal use and can detect prenatal anxiety as well as depression

Answer

It cannot be used prenatally as it was only validated postpartum

Answer

It must be combined with the PHQ-9 to have any validity in pregnancy

Answer

It detects only depression and not anxiety symptoms prenatally

Question 2

A woman at 28 weeks presents with new-onset compulsive checking behaviors (e.g., checking fetal movement 30+ times/day) that interfere with daily functioning. The clinician should first:

Accepted Answer

Assess for OCD with perinatal onset using a validated tool and explore distress and impairment

Answer

Reassure her that checking behaviors are universally normal in pregnancy

Answer

Immediately start an SSRI without further assessment

Answer

Refer to the obstetrics team for fetal monitoring to address the underlying concern

Question 3

Which prenatal anxiety presentation should prompt the clinician to specifically screen for bipolar disorder before initiating antidepressant therapy?

Accepted Answer

Anxiety alternating with periods of decreased need for sleep, elevated mood, and increased goal-directed activity

Answer

Anxiety with marked sleep disturbance and low energy

Answer

Anxiety with weight loss and poor appetite

Answer

Anxiety with prominent somatic complaints and medical utilization

Question 4

What is the significance of the 11-item Wijma Delivery Expectancy Questionnaire (W-DEQ) in perinatal anxiety assessment?

Accepted Answer

It measures fear of childbirth and is the most widely used tool for tokophobia assessment

Answer

It screens for generalized anxiety disorder severity in pregnancy

Answer

It assesses postpartum bonding anxiety after delivery

Answer

It quantifies separation anxiety related to NICU admission

Question 5

A patient at 10 weeks gestation with GAD asks if her anxiety could affect her child's long-term emotional development. Based on current evidence, which response is most accurate?

Accepted Answer

Severe, prolonged prenatal anxiety has been associated with increased emotional and behavioral problems in offspring

Answer

Prenatal anxiety has no documented effect on child emotional outcomes

Answer

Mild anxiety in pregnancy is beneficial for fetal brain development

Answer

Only postpartum anxiety affects child emotional development, not prenatal anxiety

Question 6

Which factor most distinguishes pathological health anxiety in pregnancy from normal maternal concern about fetal well-being?

Accepted Answer

Reassurance-seeking that provides only brief relief followed by return of anxiety, with significant functional impairment

Answer

The presence of any worry about fetal health

Answer

Attendance at all scheduled prenatal appointments

Answer

Use of fetal Doppler monitors at home

Question 7

A PMH-C clinician is developing a safety plan for a pregnant patient with severe anxiety who endorses passive thoughts of death ('I wish I could just sleep and not wake up'). The immediate priority is to:

Accepted Answer

Assess for active suicidal ideation, intent, and access to means, and document the risk assessment

Answer

Dismiss the statement as anxiety-related catastrophizing

Answer

Immediately hospitalize the patient on a 5150 hold

Answer

Refer to the OB team and avoid discussing suicide to prevent ideation reinforcement