A 27-year-old woman delivers her first child. On postpartum day 3 she tearfully tells the nurse she feels overwhelmed, has labile mood with sudden crying spells, and sleeps poorly, but she enjoys holding her baby and denies thoughts of harming herself or the infant. Her husband confirms she was well until delivery. The most likely diagnosis is:

• A Postpartum blues ✓
• B Major depressive disorder with peripartum onset
• C Brief psychotic disorder with postpartum onset
• D Postpartum anxiety disorder

Explanation

Postpartum blues begin within the first 2 to 3 days after delivery, peak around day 5, and remit spontaneously by two weeks without treatment. Mood lability, tearfulness, and irritability with preserved bonding and no psychosis fit this self-limited syndrome seen in up to 80 percent of mothers. The feature that excludes major depression here is the very early onset with full resolution expected by two weeks; postpartum depression typically emerges later and persists beyond two weeks.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.