Postnatal Depression — MRCPsych Paper B MCQ

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EasyPerinatal PsychiatryPostnatal DepressionMRCPsych Paper B

A 30-year-old woman is assessed 6 weeks after giving birth. For the past 4 weeks she has experienced low mood and loss of interest nearly every day, with tearfulness, fatigue, poor concentration and excessive guilt about not bonding with her baby. The symptoms are worsening and impair her daily functioning. She has no manic or psychotic symptoms. Which perinatal diagnosis is most likely?

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Correct answer: A — Postnatal depression

The correct answer is A, postnatal depression: a depressive episode occurring after childbirth. Persistent low mood, anhedonia, guilt, impaired concentration and functional impairment for 4 weeks establish a depressive syndrome rather than transient emotional lability. Baby blues typically begins shortly after delivery and resolves within 2 weeks. Postpartum psychosis usually has sudden onset and includes mania, severe confusion, delusions or hallucinations, none of which is present. Adjustment disorder is less likely because the symptoms constitute a sustained depressive syndrome rather than a subthreshold reaction to an identified stressor. Tokophobia is a severe fear of pregnancy or childbirth and does not explain this postpartum presentation.

Reference: NHS, Postnatal depression, last reviewed 18 March 2026: https://www.nhs.uk/mental-health/conditions/postnatal-depression/