Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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
Otros factores de diagnóstico
- change in psychomotor activity
- sleep disturbance
- change in appetite
- change in weight
- obsessive/intrusive thoughts
- significant self-harm or neglect or mistreatment of children
- personal or family history of hypomania or mania
- psychotic symptoms
Factores de riesgo
- history of depressed mood, depression, or anxiety
- recent stressful life events
- poor social support
- discontinuation of psychopharmacologic treatments
- sleep deprivation
- socioeconomic difficulties
- postpartum hypomania
- personality traits
- pregnancy- and delivery-related complications
- age less than 16 years
- familial and genetic factors
- physical, psychological, or sexual abuse by partner during pregnancy
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- Depression identification questions
- Edinburgh Postnatal Depression Scale (EPDS)
- Patient Health Questionnaire-9 (PHQ-9)
- Mood Disorder Questionnaire (MDQ)
Pruebas diagnósticas que deben considerarse
- Thyroid function tests
- CBC
- urine drug screen
- brain CT or MRI
Algoritmo de tratamiento
depression
Colaboradores
Autores
Arianna Di Florio, MD, PhD
Professor of Psychiatry
MRC Centre for Neuropsychiatric Genetics and Genomics
Cardiff University
Cardiff
UK
Adjunct Assistant Professor
University of North Carolina at Chapel Hill
Chapel Hill
NC
Divulgaciones
ADF is an author of references cited in this topic.
Ian Jones, MB BS, MRCPsych, PhD
Professor of Psychiatry
MRC Centre for Neuropsychiatric Genetics and Genomics
Cardiff University
Cardiff
UK
Disclosures
IJ has received grant income from Takeda. He has participated in an advisory board meeting for Sanofi and is a trustee of the Maternal Mental Health Alliance and of Action on Postpartum Psychosis. IJ is an author of references cited in this topic.
Peer reviewers
Donna Stewart, MD
Centre for Mental Health
University of Toronto
Toronto
Canada
Disclosures
DS declares that she has received author royalties from UptoDate on depression in pregnancy. DS has been an expert witness in a lawsuit related to postpartum depression.
Margaret Spinelli, MD
Associate Professor of Psychiatry
Columbia University
New York
NY
Disclosures
MS declares that she has no competing interests.
Anne-Laure Sutter, MD, PhD
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 4: screening and diagnosis of mental health conditions during pregnancy and postpartum. Jun 2023 [internet publication].Full text
National Institute for Health and Care Excellence (UK). Antenatal and postnatal mental health: clinical management and service guidance. Feb 2020 [internet publication].Full text
American College of Obstetricians and Gynecologists. ACOG clinical practice guideline no. 5: treatment and management of mental health conditions during pregnancy and postpartum. Jun 2023 [internet publication].Full text
Dennis CL, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD001134.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Minor mood disorder (postpartum blues or "baby blues")
- Postpartum (puerperal) psychosis
- Obsessive compulsive disorder
More DifferentialsGuidelines
- Screening for depression and suicide risk in adults
- Treatment and management of mental health conditions during pregnancy and postpartum
More GuidelinesPatient information
Postpartum depression
Depression in adults: questions to ask your doctor
More Patient informationLog in or subscribe to access all of BMJ Best Practice
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