Last reviewed: 3 Jul 2021
Last updated: 25 May 2021

Summary

Definition

History and exam

Key diagnostic 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 psychopharmacologic treatments
  • sleep deprivation
  • postpartum hypomania
  • personality traits
  • pregnancy- and delivery-related 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 (EPDS)
  • Mood Disorder Questionnaire (MDQ)
  • Thyroid function tests
  • CBC
  • urine drug screen
  • brain CT or MRI

Treatment algorithm

Contributors

Authors

Arianna Di Florio, MD, PhD

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.

Ian Jones, MB BS, MRCPsych, PhD

Professor of Psychiatry

MRC Centre for Neuropsychiatric Genetics and Genomics

Cardiff University

Cardiff

UK

Disclosures

IJ is an author of references cited in this topic.

Peer reviewers

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.

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