| June 2009 · Vol. 21, No. 06 LIFE ON CALL
Does your OB patient have a psychiatric complaint?
And can you manage it?
Here’s how to handle 5 challenges, including postpartum depression, an attempt to leave the hospital against advice, and denial of pregnancy
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Fast Track
The differential diagnosis for altered mood in the post partum period includes depression, baby blues, post partum psychosis, and bipolar disorder
Untreated depression can become so severe that a woman begins to experience psychosis or suicidality
If a patient is irrational, wants to leave the hospital, and lacks the capacity to make such a decision, you may need to contact the hospital’s attorney and complete an emergency detention form
Among the criteria for substance dependence are tolerance to the drug, withdrawal when the drug is cut back or stopped, and continued use of the drug despite evidence of its dangers
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Susan Hatters
Friedman,
MDDr. Friedman is Senior Instructor, Departments of Psychiatry and Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio. She is on sabbatical at the Mason Clinic, Waitemata District Health Board, Auckland, New Zealand. Jaina
Amin,
MD, BSNDr. Amin is affiliated with the Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio.
The authors report no financial relationships relevant to this article.
There’s a full moon tonight—and you’re the obstetrician on call. Not that you should expect any more funny business than usual. Despite stories of werewolves and other deviants coming out of the woodwork, there is no “full moon effect”—at least not one that can be documented. Nevertheless, chances are good that you will encounter at least one of the following psychiatric challenges as you end your day in the clinic and move on to an extended vigil:
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