Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- depressed mood
- anhedonia
- decreased energy or increased fatigability
- suicidal ideation
- loss of confidence or self-esteem
- unreasonable feelings of self-reproach or excessive and inappropriate guilt
- poor concentration
Other diagnostic factors
- change in psychomotor activity
- sleep disturbance
- change in appetite
- change in weight
- obsessive thoughts
- significant self-harm or neglect or mistreatment of children
- personal or family history of hypomania or mania
- psychotic symptoms
Risk factors
- history of depressed mood, depression, or anxiety
- recent stressful life events
- poor social support
- discontinuation of psychopharmacological treatments
- sleep deprivation
- postnatal hypomania
- personality disorder
- birth complications
- poor socioeconomic status
- age less than 16 years
- familial and genetic factors
- violence by partner during pregnancy
Diagnostic investigations
Investigations to consider
- Edinburgh Postnatal Depression Scale
- Mood Disorder Questionnaire (MDQ)
- Thyroid function tests
- FBC
- urine drug screen
- brain CT or MRI
Treatment algorithm
Contributors
Authors
Clinical Senior Lecturer
MRC Centre for Neuropsychiatric Genetics and Genomics
Cardiff University
Cardiff
UK
Disclosures
ADF is an author of references cited in this topic.
Professor of Psychiatry
MRC Centre for Neuropsychiatric Genetics and Genomics
Cardiff University
Cardiff
UK
Disclosures
IJ has received honorariums or consultancy fees from Lilly, GlaxoSmithKline, Lundbeck, Sanofi-Aventis, Janssen-Cilag, and AstraZeneca, and has received research funding from GlaxoSmithKline. IJ is also an author of references cited in this topic.
Peer reviewers
Associate Professor of Psychiatry
Columbia University
New York
NY
Disclosures
MS declares that she has no competing interests.
Head of the Perinatal Psychiatry Network
University Department of Adult Psychiatry
CH Charles Perrens
Bordeaux
France
Disclosures
ALS declares that she has no competing interests.
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