A post-natal mother who delivered 2 days back presents with increased tearfulness and sleeplessness. No features of anhedonia, suicidal thoughts or lack of interest present. Most probable diagnosis:
C i.e. Postpartum bluesRef: Kaplan and Saddock's Synopsis of Psychiatry, 11th edition and Short Textbook of Psychiatry, 7th editionExplanation:Psychological disturbances unique for women are:Related to mensesPremenstrual dysphoric disorder,Postmenopausal syndrome.Related to pregnancyAnxiety.Depression.Related to deliveryPostpartum blues,Postpartum depression,Postpartum psychosis.The above question deals with postpartum psychological problems.Postpartum bluesMild form.Characterized by occasional sadness/tearfulness.No other significant mood/psychotic/behavioral symptoms present.No significant disturbance in sleep, appetite, activities of daily living.Treatment is psychotherapy (reassurance and monitoring for symptoms).Postpartum depressionModerate form.Characterized by:Sadness, loss of interest in previous pleasurable activities (anhedonia).Easy fatigability, feeling of worthless/hopeless/helpless/guilt.Suicidal ideas/attempt, decreased appetite and sleep.Depending on the severity, psychotherapy, pharmacotherapy, ECT, may be needed.Postpartum psychosisSevere form.Characterized by psychotic symptoms (hallucination, delusion, and disorganized speech/behaviour).This condition needs treatment as inpatient basis with pharmacotherapy +- ECT.DDs for postpartum psychosis: Delirium (mostly related to events like eclampsia, hemorrhage, thrombosis, especially cortical vein thrombosis and Sheehan syndrome-postpartum pituitary gland necrosis).
Mania
Peripartum psychosis
Postpartum blues
Postpartum depression
Mood Disorders