MBBS OSCE · General Medicine
OSCE — Perinatal Psychiatry (Postnatal Depression & Postpartum Psychosis)
Eight-minute OSCE station on Perinatal Psychiatry (Postnatal Depression & Postpartum Psychosis): focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Perinatal Psychiatry (Postnatal Depression & Postpartum Psychosis).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Perinatal mental health covers psychiatric disorders arising in pregnancy and the first 12 months postpartum. Three conditions dominate and must be distinguished: baby blues (50 to 80 percent of mothers; days 2 to 14; tearfulness, mood lability; self-limiting — reassure); postnatal depression (PND) (10 to 15 percent; weeks to months postpartum; depressed mood, anhedonia, poor bonding, intrusive thoughts; screen with the Edinburgh Postnatal Depression Scale (EPDS) at 6 to 8 weeks; treat with CBT/IPT and an SSRI, sertraline preferred in breastfeeding); and postpartum (puerperal) psychosis (0.1 to 0.2 percent; onset within 2 to 4 weeks, usually the first 2 weeks; acute delusions, hallucinations
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Rapid onset of delusions, hallucinations, mania or confusion within 2 to 4 weeks |
| Safety | New mother with low mood, anhedonia, and inability to bond with infant for over |
| Safety | Postpartum woman with insomnia for 2 or more nights despite exhaustion - prodrom |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.