GP · mental-health
Perinatal mental health
Also known as Postnatal depression · Perinatal depression · Puerperal psychosis · Baby blues
GP-fellowship guide to perinatal mental health: the baby blues–PND–puerperal psychosis spectrum and urgency, EPDS screening at antenatal booking and the six-week postnatal check (Cox 1987), CBT and IPT as first-line psychological therapy for mild-to-moderate PND, sertraline as preferred SSRI in breastfeeding, antidepressant relapse risk when stopping in pregnancy (Howard meta-analysis), postpartum psychosis relapse prediction (Wesseloo), bonding/attachment impact, partner mental health, and medication weaning myths.
On this page
Study tools
Your progress
Saved on this device.
Practise this topic
Target exams
Red flags
- Puerperal psychosis is a psychiatric emergency — same-day psychiatric admission to a mother-baby unit is required; delusions about the baby or thoughts of harm demand immediate action
- Never stop an effective antidepressant abruptly in pregnancy without specialist advice — relapse risk is significantly higher with severe or recurrent depression (RR 2.30 when discontinued)
- Previous postpartum psychosis carries very high recurrence risk — plan next pregnancy proactively with psychiatry; prophylaxis started immediately after delivery minimises relapse while avoiding fetal exposure
- A mother who cannot care for her baby acutely needs same-day assessment, not a follow-up appointment in two weeks
Overview
Perinatal mental health spans the antenatal period through the first year postpartum. It is a GP consultation topic because most screening, initial management and follow-up happens in general practice — and because missing puerperal psychosis costs lives.[2]
References5ShowHide
- [1]Cox JL, Holden JM, Sagovsky R Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry, 1987.PMID 3651732
- [2]Pinheiro E, Bogen DL, Hoxha D, Ciolino JD, Wisner KL Sertraline and breastfeeding: review and meta-analysis. Arch Womens Ment Health, 2015.PMID 25589155
- [3]Wesseloo R, Kamperman AM, Munk-Olsen T, Pop VJ, Kushner SA, Bergink V Risk of Postpartum Relapse in Bipolar Disorder and Postpartum Psychosis: A Systematic Review and Meta-Analysis. Am J Psychiatry, 2016.PMID 26514657
- [4]Bayrampour H, Kapoor A, Bunka M, Ryan D The Risk of Relapse of Depression During Pregnancy After Discontinuation of Antidepressants: A Systematic Review and Meta-Analysis. J Clin Psychiatry, 2020.PMID 32558401
- [5]Leng LL, Xiao W, He X, Wang T, Ning K Efficacy of psychological treatments for perinatal depression and anxiety: systematic review and network meta-analysis. Br J Psychiatry, 2026.PMID 42343881