An Emergency Department Presentation of Postpartum Depression in the Setting of Perinatal Loss
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
Obstetric history should be carefully assessed in patients presenting to the emergency room with depression, as recent pregnancies or losses can contribute to mood instability. A 22-year-old G2P1011 woman presented to the behavioral health emergency room (BHER) with suicidal ideation, expressing intent to drink bleach. She had no prior psychiatric history, hospitalizations, or use of psychotropic medications. Initially, she denied symptoms of depression, mania, anxiety, and psychosis, attributing her suicidal statements to interpersonal conflict with the father of her 18-month-old child and other social stressors. She had a history of adolescent self-harm and used marijuana to cope. Throughout her stay in the ED, she displayed a bright affect, linear thought process, and future orientation, without evidence of mood instability or psychosis. A urine drug screen was positive for THC, while blood alcohol and pregnancy tests were negative. Collateral information from the patient’s mother revealed that she had undergone an out of-state abortion two months prior, after which she exhibited emotional lability, tearfulness, anhedonia, withdrawal from her child, and increased marijuana use. She denied prior mood instability, including postpartum depression following her first pregnancy. However, despite denying current depression, she scored 13/30 on the Edinburgh Postnatal Depression Scale, indicating possible minor or major depression. She was admitted to an inpatient psychiatric unit for suspected postpartum depression and was later discharged with close follow-up and a plan to initiate Zuranolone. This case underscores the necessity of thorough history-taking and obtaining collateral information, as patients may hesitate to disclose obstetric history due to fear of legal repercussions and social stigma. Understanding reproductive history is critical in identifying postpartum mood disorders, ensuring appropriate diagnosis and treatment.
Recommended Citation
Petrie, Jaude MD; Stuart, Sarah DO; and Rogers, Cole MS3, "An Emergency Department Presentation of Postpartum Depression in the Setting of Perinatal Loss" (2025). Dept. of Psychiatry Research Symposium. 25.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/25
An Emergency Department Presentation of Postpartum Depression in the Setting of Perinatal Loss
Center for Advanced Learning and Simulation (CALS)
Obstetric history should be carefully assessed in patients presenting to the emergency room with depression, as recent pregnancies or losses can contribute to mood instability. A 22-year-old G2P1011 woman presented to the behavioral health emergency room (BHER) with suicidal ideation, expressing intent to drink bleach. She had no prior psychiatric history, hospitalizations, or use of psychotropic medications. Initially, she denied symptoms of depression, mania, anxiety, and psychosis, attributing her suicidal statements to interpersonal conflict with the father of her 18-month-old child and other social stressors. She had a history of adolescent self-harm and used marijuana to cope. Throughout her stay in the ED, she displayed a bright affect, linear thought process, and future orientation, without evidence of mood instability or psychosis. A urine drug screen was positive for THC, while blood alcohol and pregnancy tests were negative. Collateral information from the patient’s mother revealed that she had undergone an out of-state abortion two months prior, after which she exhibited emotional lability, tearfulness, anhedonia, withdrawal from her child, and increased marijuana use. She denied prior mood instability, including postpartum depression following her first pregnancy. However, despite denying current depression, she scored 13/30 on the Edinburgh Postnatal Depression Scale, indicating possible minor or major depression. She was admitted to an inpatient psychiatric unit for suspected postpartum depression and was later discharged with close follow-up and a plan to initiate Zuranolone. This case underscores the necessity of thorough history-taking and obtaining collateral information, as patients may hesitate to disclose obstetric history due to fear of legal repercussions and social stigma. Understanding reproductive history is critical in identifying postpartum mood disorders, ensuring appropriate diagnosis and treatment.