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Chapter Initiatives

Perinatal Mood & Anxiety Disorders


The DC Collaborative for Mental Health in Pediatric Primary Care (the Collaborative) is a local public-private partnership dedicated to improving the integration of mental health in pediatric primary care for children in the District of Columbia.

The Collaborative supports PPCPs in screening for perinatal mood and anxiety disorders, such as postpartum depression, during well-child visits in the first year postpartum, and has created a Perinatal Mental Health Toolkit to aid PPCPs in this important work. The toolkit includes:

  • Summary of Mood and Anxiety Disorders During Pregnancy and Postpartum
  • Edinburgh Postnatal Depression Scale (English, Spanish and compendium of other translations)
  • Screening & Referral Algorithm and Crisis Action Plan for the Edinburgh Postnatal Depression Scale
  • Key Clinical Considerations in the Perinatal Period
  • Perinatal Mental Health Community Resources

Click here to view the Toolkit »


perinatal-video

The DC AAP Fetus and Newborn Committee conducted a series of educational sessions on identifying and responding to maternal mood and anxiety disorders.  The presentations were delivered at birth hospitals in DC to train physicians, nurses, social workers and others who care for pregnant or newly delivered mothers and their infants to recognize and act on the signs and symptoms.  Grand Rounds were held at Providence Hospital, United Medical Center, Howard Family Practice, Washington Hospital Center and Children’s National Medical Center’s Neonatology Departments.

View the video here »

DIRECTIONS ON DOWNLOADING THE VIDEO: A “preview” may be viewed by clicking right on the video. To view the full hour, the video must be downloaded. In the bottom right-hand corner of the black page, you will see three white dots. Click on those dots, and it will offer you the option to download the full video.

 

Video Outline

Outline Run-Time
Personal Introduction 00:00:00-00:01:32
Overview of different names used: PPD, PPA, the baby blues 00:01:38-00:03:00
Differentiation with “baby blues” & psychosis 00:03:07-00:04:59
Conflation of “baby blues” and psychosis with PMADs 00:05:00-00:05:36
Explanation of term PMADs: Perinatal Mood/Anxiety Disorders 00:05:37-00:06:15
Types of PMADs:
Major Depression: Symptoms, DSM listing, Diagnosing/Comorbidity w/ Anxiety 00:06:30 – 00:07:31
Bipolar Disorder: Symptoms/Timing (I & II), Incidence in the PP, Sleep Deprivation 00:07:32-00:08:45
Anxiety: symptoms, anecdote, differentiating normal vs. pathological 00:08:47-00:11:19
PTSD: symptoms, salient characteristics to the PP 00:11:20-00:12:58
Panic Disorder: Comorbidity, Symptoms 00:13:00-00:13:52
OCD:salient characteristics to the PP, differentiation from psychosis, examples 00:13:53-00:16:20
Loud noise in background 0:14:27
Camera wobble (participant banged tripod) 0:14:34
Scope of the Problem
Incidence in overall population 00:16:35-00:18:00
Incidence in lower-income populations 00:18:00-00:18:28
Suicidality 00:18:30 – 00:20:40
Effects of PMADs on Partner – cites research r.e. dads 00:20:42 -00:22:03
Effects of PMADs on Children – cites longitudinal research 00:22:04 -00:22:51
Risk Factors
Those seen in literature & two anecdotal (breastfeeding, perfectionism) 00:22:54-00:29:08
Detection/Diagnosis
Screening Tools (Edinburgh, PDSS-S, PHQs) 00:29:10-00:32:10
Clinical Judgment – weaknesses in pp population, research, “the smiling depression” 00:32:11-00:33:52
Best Practices for Screening 00:33:53-00:35:36
The Path to Wellness
Easier/Cheaper/No-cost Options 00:36:00-00:41:03
Psychotherapy: CBT, IPT 00:41:02-00:41:23
Medication: considerations r.e. pregnancy/bf, online resources 00:41:24-00:43:20
Area Resources
DC, MD & VA 00:43:21-00:44:58
Q&A 00:44:59-00:49:28