PMH-C Perinatal Mental Health Disorders & Assessment 2 — Questions and Answers
Question 1: A postpartum patient reports intrusive thoughts of accidentally dropping her baby. She is distressed by these thoughts and goes to great lengths to avoid holding the infant. Which condition is most likely?
- Postpartum psychosis
- Postpartum OCD (Correct answer)
- Postpartum depression
- Adjustment disorder
Correct answer: Postpartum OCD
Postpartum OCD is characterized by ego-dystonic intrusive thoughts (often harm-themed) that cause significant distress and avoidance behaviors, distinguishing it from psychosis.
Question 2: Which screening tool is specifically validated for use across the perinatal period, including both pregnancy and the postpartum period?
- PHQ-9
- GAD-7
- Edinburgh Postnatal Depression Scale (EPDS) (Correct answer)
- Beck Depression Inventory-II
Correct answer: Edinburgh Postnatal Depression Scale (EPDS)
The EPDS was specifically developed and validated for screening depression in perinatal women during both pregnancy and the postpartum period.
Question 3: A clinician notes that a patient's EPDS score dropped from 16 to 9 between her 6-week and 12-week postpartum visits. How should this change be interpreted?
- The patient no longer requires monitoring
- Clinical improvement has occurred but continued follow-up is warranted (Correct answer)
- The score drop confirms a misdiagnosis of PPD at the initial visit
- The score is now in the normal range and treatment can be discontinued immediately
Correct answer: Clinical improvement has occurred but continued follow-up is warranted
A score decrease suggests clinical improvement, but scores can fluctuate and ongoing monitoring is needed before concluding recovery is complete.
Question 4: Which of the following is a hallmark distinguishing feature of postpartum psychosis compared to severe postpartum depression?
- Persistent low mood
- Presence of delusions or hallucinations (Correct answer)
- Sleep disturbance
- Anhedonia
Correct answer: Presence of delusions or hallucinations
Postpartum psychosis is characterized by psychotic features such as delusions, hallucinations, and rapid mood shifts, which are not present in postpartum depression.
Question 5: During pregnancy, which anxiety disorder is most commonly reported and often goes undetected?
- Panic disorder
- Social anxiety disorder
- Generalized anxiety disorder (GAD) (Correct answer)
- Specific phobia
Correct answer: Generalized anxiety disorder (GAD)
GAD is the most prevalent anxiety disorder during pregnancy and is frequently missed because its symptoms (worry, fatigue, sleep problems) overlap with normal pregnancy experiences.
Question 6: A pregnant patient discloses she has been unable to sleep more than 2–3 hours per night, has no appetite, and feels that she is a burden to her family. Which clinical action is most urgent?
- Schedule a follow-up in two weeks
- Conduct a thorough suicide risk assessment (Correct answer)
- Refer to a nutritionist for appetite management
- Initiate sleep hygiene psychoeducation
Correct answer: Conduct a thorough suicide risk assessment
Reports of feeling like a burden, sleep deprivation, and appetite changes are warning signs for suicidality and require immediate risk assessment.
Question 7: Which timeframe represents the highest risk window for onset of postpartum psychosis?
- 6–12 months postpartum
- First 2 weeks postpartum (Correct answer)
- 3–6 months postpartum
- Immediately prior to delivery
Correct answer: First 2 weeks postpartum
Postpartum psychosis most commonly emerges within the first two weeks after delivery, often within the first 72 hours, making early postpartum monitoring critical.
PMH-C Perinatal Mental Health Disorders & Assessment 2
A postpartum patient reports intrusive thoughts of accidentally dropping her baby.
She is distressed by these thoughts and goes to great lengths to avoid holding the infant.
Which condition is most likely?