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Postpartum psychosis — MCCQE Part 1 MCQ

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HardPerinatal PsychiatryPostpartum psychosisMCCQE Part 1

29-year-old woman 10 days postpartum presents with insomnia, agitation and bizarre beliefs about the baby. She says voices tell her the infant is evil. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Arrange emergency psychiatric assessment/admission and ensure infant safety

Arrange emergency psychiatric assessment/admission and ensure infant safety is best because postpartum psychosis is a psychiatric emergency with risk to mother and infant. 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. This differs from postpartum blues or uncomplicated depression.

Reference: CANMAT perinatal mental health guidance