426 Obstetrics and Gynecology Board Review •••
❍ What are the characteristics of normal bereavement?
The following characteristics are those of normal bereavement, and can last up to 6 to 12 months (beyond
12 months, evaluation of major depression should be performed):
(1) Uncomplicated grief
(2) Crying
(3) Decreased appetite
(4) Weight loss
(5) Decreased concentration
(6) Guilt
(7) Auditory and visual hallucinations of the deceased individual
❍ What are the diagnostic criteria for major depression?
Five or more of the following symptoms that have been present for 2 weeks and at least one of the symptoms is
depressed mood or loss of interest:
(1) Marked diminished interest or pleasure in all.
(2) Weight loss or weight gain.
(3) Insomnia or hypersomnia.
(4) Psychomotor agitation or retardation.
(5) Decrease energy.
(6) Feelings of worthlessness.
(7) Inability to concentrate.
(8) Suicidal ideation.
❍ What is the lifetime prevalence of major depression?
15%.
❍ What is the name given to a common, transitory, mild depression that occurs in the first week after delivery?
What is the treatment?
Postpartum blues. This condition is self-limited and requires supportive care only.
❍ What are the criteria for diagnosing postpartum depression?
The criteria for major depressive disorder and postpartum depression are the same (“Five or more of the
[aforementioned] symptoms that have been present for 2 weeks...”). The difference being that postpartum
depression occurs, as appropriately named, during the postpartum period.
❍ What disorder is often mistaken as postpartum depression in the postpartum female? How do you rule out
this condition?
Hypothyroidism. If hypothyroidism is suspected, check serum TSH and T4.
❍ Who is more likely to complete an attempt at suicide, men or women?
Males are more likely to be successful in their attempts at suicide compared with women (3:1); however, women
attempt suicide about three times more often than men.