PMH-C Assessment and Screening 3 — Questions and Answers
Question 1: Which of the following is a validated screening tool specifically designed to assess for perinatal bipolar disorder risk?
- PHQ-9
- Mood Disorder Questionnaire (MDQ) (Correct answer)
- AUDIT-C
- Columbia Suicide Severity Rating Scale
Correct answer: Mood Disorder Questionnaire (MDQ)
The Mood Disorder Questionnaire (MDQ) is a validated self-report tool used to identify patients at risk for bipolar spectrum disorders in perinatal settings.
Question 2: A patient at her 6-week postpartum visit denies depression but reports her partner has noticed she 'seems off.' Which clinical action is most appropriate?
- Dismiss the concern since the patient denies symptoms
- Administer a standardized screening tool and conduct a collateral interview (Correct answer)
- Refer immediately to psychiatry
- Schedule a 3-month follow-up appointment
Correct answer: Administer a standardized screening tool and conduct a collateral interview
Collateral reports from partners or family members are clinically significant and should prompt formal screening and collateral interviewing even when the patient denies symptoms.
Question 3: Which clinical feature best distinguishes postpartum psychosis from severe postpartum depression during assessment?
- Persistent sadness
- Rapid cycling of mood with confusion and hallucinations (Correct answer)
- Excessive guilt about parenting
- Sleep disturbance related to infant care
Correct answer: Rapid cycling of mood with confusion and hallucinations
Postpartum psychosis is characterized by rapid mood fluctuations, confusion, disorganized thinking, and hallucinations — features not typical of postpartum depression.
Question 4: When screening for substance use in perinatal patients, which tool is commonly recommended?
- EPDS
- 4P's Plus (Correct answer)
- MDQ
- PHQ-2
Correct answer: 4P's Plus
The 4P's Plus (Parents, Partner, Past, Pregnancy) is a validated brief screening tool designed to identify perinatal substance use risk.
Question 5: An obstetric provider notices a pregnant patient has a PHQ-2 score of 3. What is the recommended next step?
- Document the score and continue routine prenatal care
- Administer the full PHQ-9 for further evaluation (Correct answer)
- Immediately prescribe an antidepressant
- Refer to social work without further assessment
Correct answer: Administer the full PHQ-9 for further evaluation
A PHQ-2 score of 3 or higher is a positive screen that warrants follow-up with the full PHQ-9 to assess severity and guide treatment planning.
Question 6: Which of the following BEST describes the purpose of universal perinatal mental health screening?
- To replace clinical judgment with standardized scores
- To identify at-risk individuals regardless of provider suspicion (Correct answer)
- To document liability in case of adverse outcomes
- To satisfy insurance billing requirements only
Correct answer: To identify at-risk individuals regardless of provider suspicion
Universal screening ensures that perinatal mental health conditions are identified in patients who may not spontaneously disclose symptoms or who appear outwardly well.
Question 7: In perinatal mental health assessment, which clinical domain is often overlooked but is critical for comprehensive evaluation?
- Sleep quality
- Infant feeding method
- Social support and relationship satisfaction (Correct answer)
- Gestational weight gain
Correct answer: Social support and relationship satisfaction
Social support and relationship quality are strong predictors of perinatal mental health outcomes and must be assessed as part of a comprehensive evaluation.
PMH-C Assessment and Screening 3
Which of the following is a validated screening tool specifically designed to assess for perinatal bipolar disorder risk?