Postnatal Depression — MRCPsych Paper B MCQ

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EasyPerinatal PsychiatryPostnatal DepressionMRCPsych Paper B

A 31-year-old woman is assessed 3 months after giving birth. For the past 4 weeks, she has experienced persistent low mood, marked loss of interest, guilt that she is a bad mother, and difficulty bonding with her baby. Her PHQ-9 score is 16. She has no manic symptoms, hallucinations, delusions or intrusive recollections of the birth. What is the most likely diagnosis?

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Correct answer: A — Postnatal depression

The correct answer is A, postnatal depression. Persistent low mood, anhedonia, excessive guilt and difficulty bonding are characteristic depressive symptoms, and they have lasted well beyond 2 weeks during the first postnatal year. The PHQ-9 score supports clinically significant depression but should form part of a full clinical assessment. Baby blues consists of mild, transient emotional lability arising shortly after delivery and usually resolves within 2 weeks. Postpartum psychosis generally has a sudden early onset with mania, severe confusion, hallucinations or delusions. Birth-related PTSD requires trauma-related features such as intrusive recollections, avoidance and hyperarousal. Tokophobia is an intense fear of pregnancy or childbirth rather than a depressive syndrome.

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