Mothers with anorexia nervosa are at high risk for having babies with:
E. The evidence here is limited and sometimes conflicting. Overall it seems that a current eating disorder, particularly active anorexia nervosa, carries an excess small risk to the mother and the foetus. A recent large cohort study published in the British Journal of Psychiatry of women with anorexia nervosa, women with bulimia nervosa, women with both disorders, and controls found that women with bulimia nervosa were significantly more likely to have a history of miscarriage and those with anorexia nervosa were significantly more likely to have smaller babies than the general population. Previous retrospective studies have found that women with a history of an eating disorder had a higher rate of miscarriage, small for gestational age babies, low birth weight babies, babies with microcephaly,intrauterine growth restriction, and premature labour.
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The percentage of people with mental illness who were in contact with psychiatric services within 1 week of suicide is:
E. Much of what we know about suicide in the UK psychiatric population is based on data collected by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. They are a relatively morbid group – more than half of patients had a secondary psychiatric diagnosis, and 16% of patients had been admitted to a psychiatric bed on more than fi ve occasions. Forty-nine per cent of the patients who died had been in contact with services in the previous week, 19% in the previous 24 hours. At fi nal contact, immediate suicide risk was estimated to be low or absent in 86% of cases. 14% were non-compliant with treatment.
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Which of the following is the best screening tool used in post-natal depression?
B. Common somatic complaints of pregnancy may be misconstrued as symptoms of depression when using traditional depression assessment scales (such as the Beck Depression Inventory, the Hamilton Rating Scale for Depression, or the Center for Epidemiological Studies Depression Scale), symptoms of depression reported by pregnant women may be misidentified as normal pregnancy-related complaints by treating obstetricians. Use of the 10-item Edinburgh Postnatal Depression Scale has been found to accurately identify depression in pregnant and postpartum women. This brief screening instrument has been validated in pregnant and postpartum populations and is easily incorporated for standard practice use in obstetrical treatment settings. Kaplan HI.
Which of the following is least associated with suicide?
E. Suicide rates are increased in all psychiatric disorders, except dementia. Most estimates of the lifetime suicide rate in schizophrenia are in the region of 5% to 10%, slightly less than in major affective disorders. The long-term risk of suicide in primary affective disorder has been estimated at 15%. Suicidal behaviour is most common among patients with depression, alcoholism or substance abuse, schizophrenia, and personality disorder. Anxiety disorders were found to be independently associated with a more than doubled risk of past and future suicidal ideation and behaviour.
Maria suffered from postpartum blues during the immediate postpartum period, what is the chance that she develops postpartum depression?
C. The most common constellation of mood symptoms experienced by women in the immediate postpartum period is typically referred to as the postpartum blues or baby blues. A relatively common phenomenon (occurring in 50–80% of women), postpartum blues include transient symptoms and rapid mood shifts, including tearfulness, irritability, anxiety, insomnia, lack of energy, loss of appetite, and the general experience of feeling overwhelmed particularly with regard to newborn care-giving tasks. By definition, the postpartum blues are transient in nature. Onset typically occurs after the third postpartum day, after the mother has left the hospital after delivery. Symptoms typically peak by day 5 and spontaneously resolve by day 10 postpartum. It has been estimated that 75% of women who experience symptoms of postpartum blues will display such a time-limited course; however, 20–25% may go on to experience full-blown postpartum depression.
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