joi, 8 decembrie 2011

Suicide Risk Among Pregnant Women And New Mothers - Health Care Professionals Should Be Aware

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Academic Journal
Main Category: Pregnancy / Obstetrics
Also Included In: Depression;  Primary Care / General Practice
Article Date: 01 Dec 2011 - 9:00 PST

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A study published online in General Hospital Psychiatry shows women at risk for suicide may be easier identified, by increasing screening of expectant and new mothers for major depression and conflicts with intimate partners.

Researchers say that even though only a small percentage of women who commit suicide are pregnant or new mothers, because this group of women commonly frequently use the health care system, they could offer significant opportunities for providers to intervene if the risk factors are better understood.

Leading researcher author Dr Katherine J. Gold, assistant professor of family medicine at the U-M Medical School states:

"We have a more complete picture now of who these women are and what led up to these tragic events. These deaths ripple through families and communities and cause a lot of sorrow and devastation."

Researchers from the University of Michigan evaluated suicide data from the unique National Violent Death Reporting System that was introduced in 2003, that links multiple sources of information and provides investigators with details, such as demographic data, mental health, pregnancy status, substance abuse status and precipitating circumstances.

The findings revealed that over half of the women who committed suicide had a known mental health diagnosis, the largest one being mood disorder, which affected 95% of women and almost half were known to being in a depressed mood before their suicide.

Senior researcher Dr Christie Palladino, an obstetrician and gynecologist with Georgia Health Sciences University's Education Discovery Institute explains:

"Previous research has shown that depressive disorders affect 14-23 percent of pregnant and postpartum women and anxiety disorders affect 10-12 percent. We've known that major depression is a factor in suicide for a long time. But this data tells us, for example, that pregnant and postpartum women had a much higher incidence of conflicts with intimate partners than their counterparts."

Researchers also observed that postnatal women seemed to have a higher tendency of being identified with a depressive mood in the two weeks before their suicide compared with other women.

Significantly, they also discovered many parallels with no substantial variations in terms of pregnancy status, such as 56% of all suicide victims had a known mental health diagnosis, 32% had tried to commit suicide before, and 28% had a known alcohol or substance abuse issue at the time of death.

Gold comments: "Depression and substance use are risk factors for everyone, including pregnant and postpartum women."

The findings showed that although suicides amongst pregnant, new postnatal and non-pregnant women shared a very similar level of education and marital status, Hispanic women had a much higher tendency of committing suicide during pregnancy (10%) or during the first year after pregnancy (9%) than women who were not pregnant (4%).

The researchers are aware that their study has some inherent data limitations, as their sample of 2,083 suicides amongst women aged between 15-54 years only included data from 17 states where data was available, and obviously it was not possible to interview victims to obtain a full examination of their mental health condition or check for unreported cases of domestic violence and other precipitating factors.

According to Gold:

"As a society, we tend to avoid talking about suicide. But it's important to try to understand and talk about risk factors if we are going to address suicide from a public health perspective."

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our pregnancy / obstetrics section for the latest news on this subject. “Mental Health, substance use, and intimate partner problems among pregnant and postpartum suicide victims in the National Violent Death Reporting System”
General Hospital Psychiatry, doi:10.1016/j.genhosppsych.2011.09.017

Source: University of Michigan Health System

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