PSI Postpartum Mood & Anxiety Disorders Knowledge 4 — Questions and Answers
Question 1: According to PSI, what is the approximate prevalence of postpartum depression among new mothers in the United States?
- 1 in 20 (5%)
- 1 in 7 (approximately 15%) (Correct answer)
- 1 in 3 (33%)
- 1 in 2 (50%)
Correct answer: 1 in 7 (approximately 15%)
PSI cites that approximately 1 in 7 women (roughly 15%) experience postpartum depression, making it the most common complication of childbirth.
Question 2: A postpartum woman endorses hearing voices telling her she is a bad mother and believing her baby has been replaced by an imposter. This is most consistent with:
- Severe postpartum depression with psychotic features (Correct answer)
- Postpartum OCD with magical thinking
- Postpartum anxiety with derealization
- Normal postpartum adjustment
Correct answer: Severe postpartum depression with psychotic features
Auditory hallucinations and delusions (such as Capgras-like belief that the baby is an imposter) in the postpartum period indicate postpartum psychosis or severe postpartum depression with psychotic features.
Question 3: Which of the following is NOT a recognized risk factor for postpartum depression according to PSI?
- Lack of social support
- History of premenstrual dysphoric disorder (PMDD)
- Vaginal delivery (versus cesarean) (Correct answer)
- Intimate partner violence
Correct answer: Vaginal delivery (versus cesarean)
Mode of delivery (vaginal vs. cesarean) is not an established independent risk factor for postpartum depression; however, a traumatic birth experience of any type can contribute.
Question 4: Brexanolone (Zulresso) is notable in postpartum depression treatment because it:
- Is the first oral medication FDA-approved specifically for postpartum depression
- Is the first IV neuroactive steroid FDA-approved specifically for postpartum depression (Correct answer)
- Is an SSRI formulation approved only for postpartum use
- Is a mood stabilizer approved to prevent postpartum psychosis
Correct answer: Is the first IV neuroactive steroid FDA-approved specifically for postpartum depression
Brexanolone (Zulresso), approved by the FDA in 2019, is the first medication specifically approved for postpartum depression; it is a synthetic analog of allopregnanolone administered intravenously.
Question 5: The Edinburgh Postnatal Depression Scale (EPDS) item 10 specifically assesses which symptom and warrants immediate follow-up if endorsed?
- Sleep disturbance
- Inability to bond with the baby
- Thoughts of self-harm or suicide (Correct answer)
- Feelings of being overwhelmed
Correct answer: Thoughts of self-harm or suicide
EPDS item 10 directly asks about thoughts of self-harm or suicide, and any positive response requires immediate clinical follow-up regardless of the total score.
Question 6: PSI's approach to postpartum mood disorders emphasizes which of the following regarding non-pharmacological treatments?
- Psychotherapy is only appropriate for mild postpartum depression
- Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are evidence-based first-line options (Correct answer)
- Exercise alone is sufficient treatment for moderate postpartum depression
- Peer support should replace professional therapy in all postpartum cases
Correct answer: Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are evidence-based first-line options
PSI endorses CBT and IPT as evidence-based psychotherapeutic approaches for perinatal mood disorders, suitable as standalone or combined with medication depending on severity.
Question 7: A postpartum woman avoiding all bathing or caring for her infant due to intrusive images of drowning the baby is most likely experiencing:
- Postpartum psychosis with command hallucinations
- Postpartum OCD with avoidance compulsions (Correct answer)
- Postpartum depression with passive death wishes
- Postpartum panic disorder triggered by water
Correct answer: Postpartum OCD with avoidance compulsions
Avoidance of situations related to intrusive harm-related thoughts is a common compulsion in postpartum OCD, and the images are ego-dystonic—the mother is acting to prevent acting on them.
PSI Postpartum Mood & Anxiety Disorders Knowledge 4
According to PSI, what is the approximate prevalence of postpartum depression among new mothers in the United States?