Abstract
We examined the utility of screening instruments to identify risk factors for suicidal ideation (SI) in a population of women with neuropsychiatric illnesses at high risk for postpartum depression. Pregnant women with neuropsychiatric illness enrolled prior to 20 weeks of gestation. Follow-up visits at 4–8-week intervals through 13 weeks postpartum included assessment of depressive symptoms with both clinician and self-rated scales. A total of 842 women were included in the study. Up to 22.3% of postpartum women admitted SI on rating scales, despite the majority (79%) receiving active pharmacological treatment for psychiatric illness. Postpartum women admitting self-harm/SI were more likely to meet criteria for current major depressive episode (MDE), less than college education, an unplanned pregnancy, a history of past suicide attempt, and a higher score on the Childhood Trauma Questionnaire. In women with a history of neuropsychiatric illness, over 20% admitted SI during the postpartum period despite ongoing psychiatric treatment. Patient-rated depression scales are more sensitive screening tools than a clinician-rated depression scale for +SI in the postpartum period.
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Funding
This study was funded by a grant from the NIH (TRCBS P50 MH-77928, SCOR P50 MH 68036). The first author also received support from the UAMS NIDA T32 grant (UL1TR000039).
Ethical approval
The original study was approved by the Emory University Institutional Review Board (IRB) on July 11, 2007 (no. 4249).
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Informed consent was obtained from all individual participants included in the study.
Conflict of interest
Drs. Coker and Magann and Mr. Tripathi have no conflicts of interest.
Dr. Pennell has received research support from the National Institutes of Health (NIH), the Epilepsy Foundation, and the Epilepsy Therapy Project, and speaker’s honoraria from the American Academy of Neurology, the American Epilepsy Society, the India Academy of Neurology, and the University of Maryland.
Dr. Newport has received research support from NARSAD and the National Institutes of Health (NIH), as well as Eli Lilly, GlaxoSmithKline (GSK), Janssen, and Wyeth Corporations, and speaker’s honoraria from Astra-Zeneca Pharmaceuticals (AZP), Eli Lilly, GSK, and Pfizer Corporations
Dr. Stowe has received research support from NIH, SAGE Therapeutics, and Janssen; consulted to GlaxoSmithKline, Pfizer, and Wyeth Corporations; and received speakers’ honoraria from the GlaxoSmithKline, Pfizer, Wyeth, Eli Lilly and Forest Corporations.
Ms. Knight’s adult son is employed by GlaxoSmithKline and has stock options as part of his employment.
No other coauthor or any family member holds equity positions in pharmaceutical or biomedical corporations.
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Coker, J.L., Tripathi, S.P., Knight, B.T. et al. Rating scale item assessment of self-harm in postpartum women: a cross-sectional analysis. Arch Womens Ment Health 20, 687–694 (2017). https://doi.org/10.1007/s00737-017-0749-2
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DOI: https://doi.org/10.1007/s00737-017-0749-2