Question 15

A 23 yo G1P1 underwent spontaneous vaginal delivery 3 weeks ago. She has no history of depression or other psychiatric disorders. She has been having difficulty sleeping, even when her baby sleeps. She has minimal energy and feels like she is failing as a mother. Her appetite is poor. She has spells of crying with acute onset. She is oriented to person, place and time. What is the most likely diagnosis?

Answer Choices:

Postpartum psychosis

Postpartum blues

Postpartum depression

Bipolar disorder

Correct Answer:

Postpartum depression

Explanation:

  • Up to 15% of women have postpartum depression

  • DSM criteria for the diagnosis of postpartum depression includes 5 of 9 symptoms that lead to significant impairment in daily functioning within the first 4 weeks postpartum (depressed mood, decreased interest, decreased energy, changes in sleep pattern, changes in weight, decreased concentration, feelings of guilt, psychomotor retardation/agitation, suicidal ideation)

  • Postpartum psychosis usually presents within 2 weeks postpartum and is rare- usually includes hallucinations, delusions and thought disorganization

  • Postpartum blues begins during the first 2-3 days and resolves within 10 days- involves mild depressive symptoms