Archives of Women's Mental Health

, Volume 15, Issue 1, pp 39–47 | Cite as

SUICIDALITY in the perinatal period: comparison of two self-report instruments. Results from PND-ReScU

  • Mauro Mauri
  • Annalisa Oppo
  • Chiara Borri
  • Susanna Banti
  • for PND-ReScU group
Original Article


The aim of this study was to assess suicidality in a non-clinical sample during the perinatal period and to report suicidality rates in women with major or minor depressive episode (MmD), assessed with the SCID, during the perinatal period. Women (1,066) were recruited at the third month of pregnancy and followed until the 12th month postpartum (N = 500). Suicidality was assessed with the MOODS-SR and with item 10 of the EPDS at different time-points during the perinatal period. The period prevalence of suicidality was 6.9% (95% CI: 6.0–7.8) during pregnancy and 4.3% (95% CI: 3.4–5.2) during postpartum, assessed with the MOODS-SR, and was 12.0% (95% CI: 10.8–13.2) during pregnancy and 8.6% (95% CI: 7.4–9.8) during the postpartum period, assessed with the EPDS. The prevalence of suicidality in women who had MmD during pregnancy was 26.4% and 34.1%, assessed with the MOODS-SR and the EPDS, respectively, while it was 18.4% (MOODS-SR) and 30.6% (EPDS) during the postpartum period. Clinicians should assess suicidality in women presenting with MmD during the whole perinatal period. Furthermore, suicidality should be assessed in women with a previous history of psychiatric disorder that reported a lifetime suicidal ideation.


Suicidality Perinatal period Perinatal depression Risk factors 



The PND-ReScU staff includes Cristina Rambelli, MD, Daniele Ramacciotti, MD, Maria Sole Montagnani, MD, Sonia Cortopassi, MD, Valeria Camilleri, MD, Amparo Bettini, D.Psych., Serena Ricciardulli, D.Psych., Serena Luisi, D.Psych., and Caterina Cirri, D.Psych. This research was funded with a grant from the Italian Ministry of Health and with liberal grants from the “Istituto per la ricerca e la prevenzione della Depressione E dell'Ansia” (IDEA), the Stella Major Foundations (no-profit advocacy associations), and Pfizer Italia. The authors would like to thank all the women who participated, without whom this study would not have been possible.


  1. American Psychiatric Association (APA) (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  2. Appleby L (1991) Suicide after pregnancy and the first postnatal year. BMJ 302:137–140PubMedCrossRefGoogle Scholar
  3. Banti S, Mauri M, Oppo A et al (2011) From the 3rd month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence and new onset of depression. Results from the perinatal depression-research & screening unit study. Compr Psychiatry 52(4):343–351 Google Scholar
  4. Borges G, Nock MK, Haro Abad JM (2010) Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. J Clin Psychiatry. (in press)Google Scholar
  5. Borri C, Mauri M, Oppo A et al (2008) Axis-I psychopathology and functional impairment at the 3rd month of pregnancy. Results from the Perinatal Depression-Research & Screening Unit (PND-ReScU) study. J Clin Psychiatry 69(10):1617–1624PubMedCrossRefGoogle Scholar
  6. Brockington I (2004) Postpartum psychiatric disorders. Lancet 363:303–310PubMedCrossRefGoogle Scholar
  7. Burt VK, Stein K (2002) Epidemiology of depression throughout the female life cycle. J Clin Psychiatry 63(7):9–15PubMedGoogle Scholar
  8. Clay EC, Seehusen DA (2004) A review of postpartum depression for the primary care physician. South Med J 97:157–161PubMedCrossRefGoogle Scholar
  9. Committee on Drugs (2000) Use of psychoactive medication during pregnancy and possible effects on the fetus and newborn. Pediatrics 105:880–887CrossRefGoogle Scholar
  10. Condon J (2010) Women's mental health: A “wish-list” for the DSM V. Arch Womens Ment Health 13:5–10PubMedCrossRefGoogle Scholar
  11. Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10 item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786PubMedCrossRefGoogle Scholar
  12. Cox JL, Murray D, Chapman GA (1993) Controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry 163:27–31PubMedCrossRefGoogle Scholar
  13. Dell'Osso L, Armani A, Rucci P et al (2002) Measuring mood spectrum. Comparison of interview (SCIMOODS) and self-report (MOODS-SR) instruments. Compr Psychiatry 43:69–73PubMedCrossRefGoogle Scholar
  14. Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO (2001) Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand 104:243–249PubMedCrossRefGoogle Scholar
  15. Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323:257–260PubMedCrossRefGoogle Scholar
  16. Fagiolini A, Dell'Osso L, Pini S et al (1999) Validity and reliability of a new instrument for assessing mood symptomatology: the Structured Clinical Interview for Mood Spectrum (SCI-MOODS). Int J Methods Psychiatr Res 8:71–82CrossRefGoogle Scholar
  17. First MB, Spitzer RL, Gibbon M et al (1995) Structured Clinical Interview for DSM-IV Axis I Disorders. New York State Psychiatric Institute, Biometrics Research, New YorkGoogle Scholar
  18. Food and Drug Administration (1979) Labeling and prescription drug advertising: content and format for labeling for human prescription drugs. Fed Regist 44:37434–37467Google Scholar
  19. Gaynes BN, Gavin N, Meltzer-Brody S et al (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ) 119:1–8Google Scholar
  20. Gold LH (2002) Postpartum disorders in primary care: diagnosis and treatment. Prim Care 29:27–41PubMedCrossRefGoogle Scholar
  21. Halbreich U, Karkun S (2006) Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J Affect Disord 91:97–111PubMedCrossRefGoogle Scholar
  22. Hawton K, van Heeringen K (2009) Suicide. Lancet 373(9672):1372–1381PubMedCrossRefGoogle Scholar
  23. Hawton K, Sutton L, Haw C et al (2005) Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. J Clin Psychiatry 66:693–704PubMedCrossRefGoogle Scholar
  24. Heron J, Connor TG, Evans J, Golding J, Glover V (2004) The Alspac study team. The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80(1):65–73PubMedCrossRefGoogle Scholar
  25. Horowitz JA, Murphy CA, Gregory KE, Wojcik J (2010) A community-based screening initiative to identify mothers at risk for postpartum depression. J Obstet Gynecol Neonatal Nurs. (in press)Google Scholar
  26. Jenkins R (2002) Addressing suicide as a public-health problem. Lancet 359(9309):813–814PubMedCrossRefGoogle Scholar
  27. Kitamura T, Yoshida K, Okano T, Kinoshita K, Hayashi M, Toyoda N et al (2006) Multicentre prospective study of perinatal depression in Japan: incidence and correlates of antenatal and postnatal depression. Arch Womens Ment Health 9:121–130PubMedCrossRefGoogle Scholar
  28. Lewis G (2004) Confidential enquiry into maternal and child health. Why mothers die 2000–2002. Sixth report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. Ch. 11A: Deaths from suicide and other psychiatric causes. RCOG Press, LondonGoogle Scholar
  29. Lindahl V, Pearson JL, Colpe L (2005) Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 8(2):77–87PubMedCrossRefGoogle Scholar
  30. Luoma I, Tamminen T, Kaukonen P et al (2001) Longitudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Adolesc Psychiatry 40:1367–1374PubMedCrossRefGoogle Scholar
  31. Manber R, Blasey C, Allen JJ (2008) Depression symptoms during pregnancy. Arch Womens Ment Health 11(1):43–48PubMedCrossRefGoogle Scholar
  32. Mann JJ (2003) Neurobiology of suicidal behavior. Nat Rev Neurosci 4:819–828PubMedCrossRefGoogle Scholar
  33. Moller HJ (2003) Suicide, suicidality and suicide prevention in affective disorders. Acta Psychiatr Scand 418:73–80CrossRefGoogle Scholar
  34. Mota NP, Burnett M, Sareen J (2010) Associations between abortion, mental disorders, and suicidal behaviour in a nationally representative sample. Can J Psychiatry 55(4):239–247PubMedGoogle Scholar
  35. Oates M (2003) Perinatal psychiatric disorders: a leading cause of maternal morbidity and mortality. Br Med Bull 67:219–229PubMedCrossRefGoogle Scholar
  36. O'Hara M, Swain A (1996) Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54CrossRefGoogle Scholar
  37. Oquendo MA, Currier D, Mann JJ (2006) Prospective studies of suicidal behavior in major depressive and bipolar disorders: what is the evidence for predictive risk factors? Acta Psychiatr Scand 114(3):151–158PubMedCrossRefGoogle Scholar
  38. Pinheiro RT, da Silva RA, Magalhães PV, Horta BL, Pinheiro KA (2008) Two studies on suicidality in the postpartum. Acta Psychiatr Scand 118(2):160–163PubMedCrossRefGoogle Scholar
  39. Reck C, Struben K, Backenstrass M et al (2008) Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiatr Scand 118:459–468PubMedCrossRefGoogle Scholar
  40. Sit D, Seltman H, Wisner KL (2011) Seasonal effects on depression risk and suicidal symptoms in postpartum women. Depress Anxiety 28(5):400–405PubMedCrossRefGoogle Scholar
  41. Skouteris H, Wertheim EH, Rallis S, Milgrom J, Paxton SJ (2009) Depression and anxiety through pregnancy and the early postpartum: an examination of prospective relationships. J Affect Disord 113:303–308PubMedCrossRefGoogle Scholar
  42. Sokero P, Melartin T, Rytsala H et al (2003) Suicidal ideation and attempts among psychiatric patients with major depressive disorder. J Clin Psychiatry 64:1094–1100PubMedCrossRefGoogle Scholar
  43. Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H (2004) Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatr 19:459–463CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Mauro Mauri
    • 1
  • Annalisa Oppo
    • 1
    • 2
  • Chiara Borri
    • 1
  • Susanna Banti
    • 1
  • for PND-ReScU group
  1. 1.Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, School of MedicineUniversity of PisaPisaItaly
  2. 2.Department of PsychologyUniversity of ParmaParmaItaly

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