Perinatal mood and anxiety disorders (PMADs) are the most common complication of childbirth. When poorly controlled, they are associated with worse obstetric outcomes, such as higher rates of preterm birth and unplanned cesarean delivery. They are also associated with suicide, a leading cause of perinatal maternal death. This article provides an overview of evidence-based recommendations for screening, assessment, and management of PMADs, including suicide risk assessment and management and pharmacological and nonpharmacological treatment options compatible with pregnancy and lactation. Although specialized reproductive psychiatrists can provide expert guidance for the management of PMADs, their scarcity means that most patients will not have access to this expert care and instead will seek guidance from general psychiatrists. This article provides a clinical guide for generalists that is based on the best current evidence, including recently released treatment guidelines.
PMID 38694149 38694149 DOI 10.1176/appi.focus.20230023 10.1176/appi.focus.20230023 Weingarten et al. 2024, Weingarten 2024
Cite this article
Weingarten, S. J., & Osborne, L. M. (2024). Review of the Assessment and Management of Perinatal Mood and Anxiety Disorders. Focus (American Psychiatric Publishing), 22(1), 16-24. https://doi.org/10.1176/appi.focus.20230023
Weingarten SJ, Osborne LM. Review of the Assessment and Management of Perinatal Mood and Anxiety Disorders. Focus (American Psychiatric Publishing). 2024;22(1):16-24. doi:10.1176/appi.focus.20230023
Weingarten, S. J., and L. M. Osborne. "Review of the Assessment and Management of Perinatal Mood and Anxiety Disorders." Focus (American Psychiatric Publishing), vol. 22, no. 1, 2024, pp. 16-24.
Keywords
Perinatal mood and anxiety disorders, Postpartum depression, Postpartum psychosis, Pregnancy
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The first 3 postpartum months represent a high-risk period for psychiatric illnesses. This article reviews the prevalence and diagnostic criteria for postpartum illnesses, including the "maternal blues," postpartum depression, and postpartum psychosis. Pharmacologic treatment of these disorders is often complicated by a patient's desire to breast-feed, yet there are no controlled trials of antidepressant treatment during lactation. Infant exposure and limitations to monitoring infant sera are reviewed. Lastly, a model and guide for reducing fetal and infant exposures is presented.
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