![]() This DSM-5 does not recognize postpartum blues as its own separate diagnosis. Postpartum depression and postpartum psychosis are now classified as one diagnosis, namely "depressive disorders with peripartum onset" and differentiated with the classifier “with psychotic features” if psychotic features are present. This symptomatic presentation used to formerly be referred to under its own diagnostic classification as postpartum psychosis. Under the updates proposed in the fifth edition of the new Diagnostic and Statistical Manual of Mental Disorders, postpartum depression is re-defined as “depressive disorder with peripartum onset.” In rare cases, psychotic features may accompany the primary symptoms of depression. A clinical tool that can be useful to screen for postpartum depression is the Edinburgh Postpartum Depression Scale, which has been validated to have adequate sensitivity and specificity across population groups, even when assessing changes in depression over time. ![]() If the symptoms persist beyond two weeks, the diagnostic criteria for postpartum depression are then fulfilled. ![]() These symptoms, when present, should not meet the criteria for major depressive disorder or, when occurring in the postpartum period, of postpartum depression. To fully meet the criteria for a diagnosis of postpartum blues, the symptoms usually develop within two to three days of delivery and resolve within two weeks. Symptoms of postpartum blues include crying, dysphoric affect, irritability, anxiety, insomnia, and appetite changes. Other studies have also proposed that elevated monoamine oxidase levels or decreased serotoninergic activity in the immediate postpartum period are also significant risk factors or etiological characteristics that could predispose a woman to the development of postpartum blues. Īccording to one particular study, the three predisposing factors most often found in women who developed postpartum blues were higher levels of depressive symptoms during pregnancy, at least one previous episode of diagnosed depression, and a history of premenstrual depression or other menstrual-related mood changes. The decrease in these hormones is also noted in the mood changes that occur during the various phases of the menstrual cycle, such as those noted in premenstrual dysphoric disorder. Typically, there is a drastic decrease in estradiol, progesterone, and prolactin in the time following delivery. However, hormonal changes have long been suggested as one of the primary causative factors in developing postpartum mood changes. ![]() cesarean), family history of mood disorders, or history of postpartum depression in the past. unplanned pregnancy, spontaneous pregnancy vs. The factors that, when present, do not predispose a patient to the development of postpartum blues: low economic status, ethnic or racial background, gravidity status (primiparous vs. These include a history of menstrual cycle-related mood changes or mood changes associated with pregnancy, a history of major depression or dysthymia, a larger number of lifetime pregnancies, or a family history of post-partum depression. Several risk factors can lead to the development of postpartum blues. ![]()
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