PMH-C Treatment Interventions 2 — Questions and Answers
Question 1: Which psychotherapy is considered a first-line evidence-based treatment for postpartum depression?
- Psychodynamic therapy
- Cognitive-behavioral therapy (CBT) (Correct answer)
- Hypnotherapy
- Gestalt therapy
Correct answer: Cognitive-behavioral therapy (CBT)
CBT is a first-line evidence-based treatment for postpartum depression, targeting negative thought patterns and behaviors.
Question 2: A mother with perinatal OCD is avoiding bathing her newborn due to intrusive harm thoughts. The MOST appropriate evidence-based treatment approach is:
- Supportive counseling only
- Exposure and Response Prevention (ERP) (Correct answer)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Dialectical Behavior Therapy (DBT)
Correct answer: Exposure and Response Prevention (ERP)
ERP is the gold-standard behavioral treatment for OCD, including perinatal OCD, by systematically reducing avoidance behaviors.
Question 3: When prescribing an SSRI to a breastfeeding mother with severe postpartum depression, which medication has the most safety data and is generally preferred?
- Fluoxetine
- Sertraline (Correct answer)
- Paroxetine
- Citalopram
Correct answer: Sertraline
Sertraline has the most robust safety data in breastfeeding, with low infant plasma levels and no reported adverse events.
Question 4: Interpersonal Therapy (IPT) for perinatal depression primarily focuses on:
- Unconscious conflicts from childhood
- Role transitions, grief, and interpersonal disputes (Correct answer)
- Behavioral activation and scheduling
- Mindfulness and radical acceptance
Correct answer: Role transitions, grief, and interpersonal disputes
IPT addresses role transitions (e.g., becoming a mother), grief, and interpersonal conflicts that contribute to perinatal depression.
Question 5: A pregnant woman with severe depression refuses medication due to teratogen concerns. The most appropriate alternative somatic treatment to consider is:
- Electroconvulsive therapy (ECT) (Correct answer)
- Transcranial magnetic stimulation (TMS)
- Light therapy only
- Acupuncture
Correct answer: Electroconvulsive therapy (ECT)
ECT is safe in pregnancy and is indicated for severe, treatment-resistant depression when medication refusal or risk is prohibitive.
Question 6: Which of the following best describes the role of peer support in perinatal mental health treatment?
- It replaces professional therapy for moderate-to-severe illness
- It reduces isolation and shame while complementing professional care (Correct answer)
- It is only effective for mild anxiety
- It should be avoided until symptoms remit
Correct answer: It reduces isolation and shame while complementing professional care
Peer support reduces stigma, social isolation, and shame and works best as an adjunct to, not replacement for, professional treatment.
Question 7: Brexanolone (Zulresso) is distinct from traditional antidepressants because it:
- Blocks dopamine reuptake in the nucleus accumbens
- Acts as a GABA-A receptor positive allosteric modulator targeting allopregnanolone pathways (Correct answer)
- Inhibits serotonin and norepinephrine reuptake simultaneously
- Blocks glutamate NMDA receptors
Correct answer: Acts as a GABA-A receptor positive allosteric modulator targeting allopregnanolone pathways
Brexanolone is a synthetic analog of allopregnanolone that modulates GABA-A receptors, addressing the neurobiological mechanism specific to postpartum depression.
PMH-C Treatment Interventions 2
Which psychotherapy is considered a first-line evidence-based treatment for postpartum depression?