1. Perinatal Psychiatry Key Points for GPs
Dr Zena Schofield
June 2018

2. Red Flags
‘Red Flag’ presentations which should prompt urgent senior psychiatric assessment
-- Recent significant change in mental state or emergence of new symptoms
-- New thoughts or acts of violent self-harm
-- New and persistent expressions of incompetency as a mother or estrangement from the infant

3. Summary Anti-depressants in pregnancy- TCAs and SSRIs
Anti-depressants in breast feeding- preference for SERTRALINE or Imipramine
Anti-psychotics in pregnancy- get 2ndary MH services involved
Active management of serious perinatal mental illnesses by our specialist team
Milder perinatal MH difficulties are managed in primary care

4. Differences Perinatal vs Adult
Lower threshold because:
Can rapidly change early postpartum or late pregnancy
Violent means of suicide
Changes in presentation is important
Mum & baby (& family)- risks, social services
Not always looking to prevent admission to MBU
Involve perinatal at an early stage

5. Who to refer Serious mental illness-whether well or ill
PHx severe depression- esp post-partum
Current symptoms of mod depression or mod-severe anxiety disorder
Pre-conceptual counselling appts
Accept from 13/40 to max 12/12pp
Advice given at any stage in pregnancy by perinatal team

6. Perinatal Team contact details
Office (normal working hours)
Urgent referrals phone first
Refer by secure or letter or fax
Advice available from perinatal team
Address from : Green Haven Perinatal Unit, Hopewood, Foster Drive, Nottingham, NG5 3FL