Quiz 5: Special medical issues in maternal mental health

Please choose the one, most correct answer to each question or statement.

Which statement about HIV and mental illness is correct?
- HIV-positive women are usually mentally ill
- Pregnant HIV-positive mothers will have babies that are mentally ill
- Mental illness is more common among HIV-positive women
- ARV treatment usually makes mothers mentally ill
What difficulties may HIV-positive mothers face after the birth of their baby?
- Difficulties deciding how best to feed their infant
- Difficulties in getting their partners to feed the infant
- Difficulties in changing nappies due to loss of muscle tone
- Difficulties in breastfeeding due to inverted nipples
How can mental illness affect HIV?
- It does not as they are separate illnesses
- Poorer adherence to HIV management, e.g. PMTCT or ART
- Mental wellbeing means you won’t get HIV
- Mental illness automatically lowers the CD4 count
What is substance misuse?
- Occasional use of alcohol in a social setting
- Use of illegal drugs on one occasion
- Harmful use of alcohol or drugs for non-medical purposes
- Use of any drugs for medical purposes
How does substance misuse affect mental health?
- Drugs to treat mental illness make one an addict
- Both substance misuse and mental disease are untreatable
- All mentally ill people need illegal substances to cope with reality
- Mentally ill people may use alcohol or drugs in an attempt to make themselves feel better
What signs of substance misuse can be confused with signs of depression or anxiety?
- Being sociable and wanting to party
- Being thirsty and wanting to drink
- Agitation or mood swings
- Being responsible and taking care of one’s appearance
What is the best approach to finding out if a mother is misusing substances?
- Ask if she has used alcohol or drugs in the past
- Be direct and ask her if she is drunk
- Check her bag for alcohol or drugs
- Tell her that you think she is an alcoholic and ask if this is true
Which of the following statements about suicide is true?
- Suicidal people always want to die
- Suicide usually happens without warning
- Suicide is an important cause of maternal mortality
- Improvement following a suicidal crisis means that the crisis is over
How common is postnatal suicide in South Africa?
- It is the most common cause of postnatal death
- The risk of suicide after delivery is high
- It is only common in women who have attempted suicide before pregnancy
- It is uncommon
Which of the following is a sign that a woman may be at risk of suicide?
- She is a person who ‘acts out’ rather than ‘talking out’ her problems
- She is a person who enjoys others’ company but now says they are boring to her
- She has done lots of shopping for the baby, planning for the birth
- She has complained of putting on too much weight and is feeling uncomfortable with the pregnancy
What can a care provider say to help a suicidal pregnant woman?
- Think about your baby!
- This is just your hormones, you will feel better soon
- Do you really think that this is going to solve all the problems?
- It sounds like you have more emotional pain than you can cope with and need help in deciding how to cope
What help may a care provider need when she has dealt with a suicidal mother?
- A stiff drink
- Debriefing and support
- Nothing special, this is what you are trained to do
- A thank-you letter from the suicidal woman
How often does postnatal psychosis occur?
- With all women who were depressed before they gave birth
- With all women who are bipolar when pregnant
- 1 in 100 births
- 1 in 1000 births
Which of the following symptoms could indicate postnatal psychosis?
- Feeling tired following a difficult delivery
- Feeling joyful after the birth of a healthy baby
- Feeling paranoid once the baby is breastfeeding normally
- Feeling fearful and suspicious prior to birth when told of other women’s stories of delivery
Which of the following is a treatment for postnatal psychosis?
- Vitamin B12 injection
- Antipsychotic medication
- Hysterectomy
- No treatment is available
Which of the following statements about postnatal psychosis is true?
- Women can improve quickly with the right treatment
- Women will only improve very slowly and they need a lot of time, sometimes years to recover
- Women who have had postnatal psychosis will never be mentally healthy
- Women who have had postnatal psychosis will always be out of touch with reality in subsequent pregnancies
How does losing a baby affect a woman’s mental health?
- It does not because it is a physical problem only
- She may be in shock and unable to believe what has happened
- Her mental illness may have caused the loss
- Blood loss from a miscarriage affects the functioning of the brain, causing mental illness
How can a health worker help a woman who has just had a miscarriage?
- Clean up quickly so that she can be left alone to grieve
- Explain that it must have been caused by something that she ate or drank
- Explain that as many as a third of pregnancies can miscarry, it is not her fault
- Tell her that the fetus was probably deformed and it is better that it did not survive
How can a health worker help a woman who has had a stillbirth?
- Carry the baby out of the room quickly so that the parents don’t see it
- Ignore the parents if they are angry as it is not your fault
- There is nothing you can do to help, what has happened is the way the world works
- Treat the infant gently at birth, wrap it in blankets and show respect
Do care providers need support after helping parents cope with pregnancy loss?
- Loss is part of life, so they must just deal with it
- Care providers may need to talk to someone for debriefing
- Loss is upsetting so they should take sick leave to grieve alone
- They are trained professionals so they should manage the stress