PSI Postpartum Mood & Anxiety Disorders Knowledge 2 â Questions and Answers
Question 1: Which postpartum mood disorder is characterized by intrusive, ego-dystonic thoughts that the mother finds deeply disturbing and inconsistent with her values?
- Postpartum depression
- Postpartum OCD (Correct answer)
- Postpartum psychosis
- Postpartum PTSD
Correct answer: Postpartum OCD
Postpartum OCD involves unwanted intrusive thoughts (e.g., harming the baby) that are ego-dystonic, meaning they conflict with the mother's values and cause significant distress.
Question 2: A new mother reports flashbacks, nightmares, and hypervigilance following a traumatic birth experience. Which postpartum condition is most likely?
- Postpartum anxiety
- Postpartum depression
- Birth-related PTSD (Correct answer)
- Postpartum psychosis
Correct answer: Birth-related PTSD
Birth-related PTSD presents with classic PTSD symptomsâflashbacks, nightmares, avoidance, and hyperarousalâtriggered by a traumatic labor or delivery experience.
Question 3: According to PSI guidelines, postpartum panic disorder is best described as:
- Persistent low mood with anhedonia lasting more than two weeks
- Recurrent unexpected panic attacks with anticipatory fear of future attacks (Correct answer)
- Intrusive thoughts paired with repetitive checking behaviors
- Grandiosity and decreased need for sleep in the postpartum period
Correct answer: Recurrent unexpected panic attacks with anticipatory fear of future attacks
Postpartum panic disorder features recurrent, unexpected panic attacks and persistent worry about having more attacks, which is distinct from generalized postpartum anxiety.
Question 4: Postpartum rage is increasingly recognized as a symptom most commonly associated with which condition?
- Postpartum psychosis
- Postpartum OCD
- Postpartum depression (Correct answer)
- Postpartum PTSD
Correct answer: Postpartum depression
Postpartum rage and irritability are recognized presentations of postpartum depression, which does not always manifest as sadness alone.
Question 5: Which factor is considered the STRONGEST single predictor of postpartum depression?
- Unplanned pregnancy
- History of depression or anxiety during pregnancy (Correct answer)
- Cesarean delivery
- First-time parenthood
Correct answer: History of depression or anxiety during pregnancy
Antenatal depression or anxiety is the strongest predictor of postpartum depression; women who are depressed or anxious during pregnancy are at substantially elevated risk.
Question 6: How does postpartum OCD most critically differ from postpartum psychosis regarding infant safety risk?
- Postpartum OCD poses higher infant risk because compulsions are uncontrollable
- Postpartum psychosis poses higher infant risk because thoughts may be ego-syntonic and acted upon (Correct answer)
- Both pose equal risk since intrusive thoughts occur in both conditions
- Postpartum OCD poses higher risk due to the mother's impaired reality testing
Correct answer: Postpartum psychosis poses higher infant risk because thoughts may be ego-syntonic and acted upon
In postpartum psychosis, command hallucinations or delusional beliefs can be ego-syntonic and may lead to acting on harmful thoughts, whereas OCD intrusive thoughts are ego-dystonic and rarely acted upon.
Question 7: A lactating mother with moderate postpartum depression asks about antidepressant options. Which class is generally considered first-line due to its established safety profile in breastfeeding?
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Benzodiazepines
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs such as sertraline and paroxetine have the most robust safety data during breastfeeding and are considered first-line pharmacological treatment for postpartum depression.
PSI Postpartum Mood & Anxiety Disorders Knowledge 2
Which postpartum mood disorder is characterized by intrusive, ego-dystonic thoughts that the mother finds deeply disturbing and inconsistent with her values?