PPD Quiz Your quiz score was out of 22. Your incorrect answers have been highlighted below. Understanding PPD 1. A woman enters the clinic 3 months after delivery presenting with low mood and poor energy over the last 3 weeks. She is most likely experiencing: a. Postpartum blues b. Postpartum depression c. Postpartum anxiety disorder d. Postpartum psychosis e. Normal postpartum adjustment 2. When determining whether or not a woman has PPD, you should rule out all of the following EXCEPT: a. Postpartum psychosis b. Diabetes c. Lactose intolerance d. Anemia e. Thyroid dysfunction 3. Which of the following is NOT a risk factor for PPD? a. Having an unplanned pregnancy b. Women with a history of infertility c. Living in a rural area d. Having a baby as a teen e. Giving birth by cesarean section 4. Which of the following statements are true about the relations among postpartum blues, postpartum depression, and postpartum psychosis? a. They all represent one postpartum syndrome that varies in severity of symptoms. b. Postpartum blues and depression represent one syndrome, but postpartum psychosis is a separate syndrome. c. They are separate syndromes that sometimes occur together in the same woman. d. Postpartum psychosis is basically a form of severe postpartum depression. 5. The peak time of onset of postpartum depression is: a. Within the first 2 weeks after delivery b. Within the first 3 months after delivery c. Approximately 4–6 months after delivery d. There is no peak time 6. Which of the following is a consequence of postpartum depression? a. The consequences of postpartum depression are wide ranging and affect the mother, infant, and the whole family b. The consequences of postpartum depression are severe but primarily affect the mother c. The consequences of postpartum depression are severe but primarily affect the child d. The consequences of postpartum depression affect the whole family, but they are limited in duration to the first 6 months after delivery Assessing PPD 1. Identify the unique advantage of the Edinburgh Postnatal Depression Scale a. Brief self-report measure b. Contains PPD relevant content beyond just symptoms c. Widely and successfully used around the world d. Contains questions that allow a tentative PPD diagnosis e. Easy to administer 2. Identify the unique advantage of the Postpartum Depression Screening Scale a. Brief self-report measure b. Contains PPD relevant content beyond just symptoms c. Widely and successfully used around the world d. Contains questions that allow a tentative PPD diagnosis e. Easy to administer 3. Under which circumstance is further assessment NOT necessary? a. A woman has a score of 13 on the EPDS b. A woman has a score of 13 on the PDSS short form c. A woman has a score of 13 on the PHQ-9 d. A woman indicates “yes” or has a score of 2 on a red-flag item e. A woman indicates that she has not felt depressed and had not had interest or pleasure in doing things since having the baby 4. When developing a screening and assessment protocol, you should avoid: a. Screening women who have a history of depression or have other risk factors for PPD b. Assigning clear roles to staff and involve all staff in the process c. Encouraging staff to ask women questions rather than using the screening tools if that is what the staff member prefers d. Placing posters and other PPD information in the waiting room e. Establishing a referral network with mental health providers and other organizations that provide services for women with PPD 5. Which of the following is NOT necessarily an indication for referral? a. A woman is reporting symptoms of bipolar disorder b. A woman reports hearing voices telling her to harm her baby c. A woman has a disturbing thought to throw her baby out the window d. After two medication trials, a woman is still experiencing moderate PPD symptoms e. A woman wishes to see a therapist 6. Following a positive screen, your clinical assessment determines that your patient is probably not experiencing a major depression. Which of the following options might be your best course of action? a. Communicate to your patient that she is not depressed and that she should feel better soon. b. Refer her for treatment anyway because it is likely that the depression symptoms will evolve in a full-blown major depression. c. Let the patient know that she should contact you again in a couple of weeks if she is not feeling better. d. Start your patient on a low dose of an antidepressant to address the minor symptoms. 7. Some patients do not acknowledge their depression to their primary care physician. What is a common reason? a. Belief that depression symptoms are normal b. Lack of trust in her provider c. Belief that depression is not interfering in her life d. Her depression is being managed by a mental health professional 8. In making a diagnosis of postpartum depression, it is important to: a. Identify the timing of onset of the depression b. Make the patient recognizes she is depressed c. Establish a clear link between childbirth and the depressive episode d. Verify that the patient’s episode meets diagnostic criteria for major depression Treating PPD 1. Which of the following statements is true about the empirical support for the use of antidepressant medication and psychotherapy in the treatment of postpartum depression? a. There is solid empirical support for the use of medication for postpartum depression. b. There are numerous randomized controlled trials supporting various psychotherapies for postpartum depression. c. Alternative and complementary therapies such as massage and herbal medications are indicated for postpartum depression. d. There is very little evidence addressing the efficacy of medication or psychotherapy for postpartum depression. 2. Which of the following treatments should NOT be considered as first-line treatment for a breastfeeding mother with moderate levels of depression? (Check all that apply) a. Selective serotonin reuptake inhibitors b. The same antidepressant her sister takes c. Interpersonal psychotherapy d. Cognitive-behavioral therapy e. Peer Support 3. Which of the following is NOT a method to engage women in treatment? a. Listening b. Encouraging medication compliance c. Maintaining positive regard for the woman d. Taking a collaborative stance e. Providing reassurance and education 4. A risk assessment is required in all but which of the following cases? a. A woman refuses treatment b. A woman endorses suicidal ideation c. A woman scores 21 on the EPDS d. A woman reports domestic abuse e. A woman shows signs of postpartum psychosis 5. Place the following medication consideration in order of importance, from most important to least: 1) Use a selective serotonin reuptake inhibitor 2) Use a medication that the woman used successfully to treat previous episodes of depression 3) Use the medication preferred by the patient 4) Use the medication that the woman’s mother is using successfully to treat her depression a. 2, 4, 3, 1 b. 1, 3, 2, 4 c. 3, 2, 4, 1 d. 2, 3, 1, 4 e. 3, 1, 4, 2 6. Which of the following is NOT a primary treatment for PPD? a. Interpersonal psychotherapy b. Cognitive therapy c. Electroconvulsive therapy d. Nutritional changes and exercise e. Antidepressant medication 7. When conducting follow-up in primary care… a. No follow-up is needed if the patient was referred to another provider b. Follow up with the patient at your next regular visit c. Follow up with the woman within 4 weeks of starting treatment, and every 4–8 weeks during treatment, if you are providing treatment d. Periodically assess treatment effectiveness and make adjustments as needed e. Discontinue medications once the woman feels better 8. Your patient is currently on an adequate dose of an SSRI, but she is still socially isolated and very unsure of her parenting skills. Which of the following non-pharmacological treatments would you recommend to supplement her use of medication? a. Marriage counseling b. Support group c. Exercise d. Light therapy e. Acupuncture Grade Quiz!