A 25-year-old woman comes to the office accompanied by her husband. She is 1 week postpartum and has been sleeping poorly and crying for no reason. The patient's pregnancy and vaginal delivery were uncomplicated. She has some anxiety about being a new mother but says that her mother is helping and the baby is doing well. The patient says, "I was thrilled after giving birth and can't understand why I now feel so tense and unhappy." Her husband adds that his wife is uncharacteristically irritable and they fight frequently. Last night she yelled at him for failing to help with the baby's nighttime feeding and later felt remorseful for her behavior. The patient has a history of a major depressive episode that began after she moved away from home for college but responded well to psychotherapy and fluoxetine. She has no other medical problems, takes no medication and is not breastfeeding. Mental status examination shows a visibly tired woman with tense affect. She has no suicidal or homicidal ideation. Which of the following is the most appropriate intervention?
A)Cognitive-behavioral therapy
B)Fluoxetine
C)Interpersonal psychotherapy
D)Mirtazapine
E)Psychiatry consultation
F)Reassurance and monitoring
G)Sertraline

Question

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The Answer of A 25-year-old woman comes to the office accompanied by her husband.  She is 1 week postpartum and has been sleeping poorly and crying for no reason.  The patient's pregnancy and vaginal delivery were uncomplicated.  She has some anxiety about being a new mother but says that her mother is helping and the baby is doing well.  The patient says, "I was thrilled after giving birth and can't understand why I now feel so tense and unhappy."  Her husband adds that his wife is uncharacteristically irritable and they fight frequently.  Last night she yelled at him for failing to help with the baby's nighttime feeding and later felt remorseful for her behavior.  The patient has a history of a major depressive episode that began after she moved away from home for college but responded well to psychotherapy and fluoxetine.  She has no other medical problems, takes no medication and is not breastfeeding.  Mental status examination shows a visibly tired woman with tense affect.  She has no suicidal or homicidal ideation.  Which of the following is the most appropriate intervention?

A 25-Year-Old Woman Comes to the Office Accompanied by Her