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Postpartum depression — MCCQE Part 1 MCQ

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ModeratePostpartumPostpartum depressionMCCQE Part 1

30-year-old woman 6 weeks postpartum presents with low mood and guilt. She has poor sleep unrelated to the infant and passive thoughts that family would be better off without her. Which of the following is the most appropriate next step?

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Correct answer: C — Assess suicide/infanticide risk urgently and initiate treatment/support

Assess suicide/infanticide risk urgently and initiate treatment/support is best because postpartum depression with passive death thoughts requires direct risk assessment. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Do not dismiss symptoms as normal postpartum tiredness.

Reference: CANMAT perinatal depression guidance