Last reviewed: March 2020
Last updated: July  2019

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
More investigations to consider

Treatment algorithm

Contributors

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 reviewersVIEW ALL

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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