Suicidal ideation in pregnancy: Assessment and clinical implications

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Archives of Women s Mental Health (Impact Factor: 2.16). 02/2007; 10(5):181-7. DOI: 10.1007/s00737-007-0192-x
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The objectives of this study were 1) to determine the prevalence of suicidal ideation (SI) in pregnant women with a history of neuropsychiatric illness, 2) to assess the relative sensitivity of commonly used depression rating scales for detecting SI, and 3) to examine the sociodemographic and clinical predictors of SI in pregnant women. Demographic data, Beck Depression Inventory [BDI] and Hamilton Rating Scale for Depression [HRSD] questionnaires, and SCID interviews were obtained from 383 pregnant women presenting to the Emory Women's Mental Health Program or the Emory Women's Epilepsy Program. Among those who completed both scales, 29.2% endorsed SI on the BDI and 16.9% on the HRSD, with 33.0% endorsing SI on at least one of the rating scales and 13.1% on both rating scales. The rate of SI endorsement on the BDI was 73.3% higher than the HRSD. Multivariate logistic regression demonstrated that SI in pregnant women was associated with unplanned pregnancy (OR = 2.97), current major depression (OR = 4.12), and comorbid anxiety disorder (OR = 4.17). Further studies are warranted to identify additional predictors of perinatal suicidality and to clarify the nature of the association between such factors and the presence of SI in pregnant women.

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    • "), the Patient Health Questionnaire – PHQ (Gavin et al., 2011), the Beck Depression Inventory – BDI (Newport et al., 2007), or the Hamilton Rating Scale for Depression —HRSD (Newport et al., 2007). An additional strength was the inclusion in the analysis of several variables that are known to be associated with CSR. "
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    ABSTRACT: This study aimed to describe the prevalence of psychiatric disorders and to identify the factors associated with Current Suicide Risk (CSR) in the first trimester of pregnancy. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was employed to diagnose mental disorders in 239 women enrolled in a prospective cohort in Rio de Janeiro, Brazil. Serum lipids, leptin and socio-economic status were the independent variables. CSR, the dependent variable, was entered as binary (yes/no) variable into crude and adjusted Poisson regression models with robust variances. CSR was found to be the main psychiatric syndrome (18.4%), followed by agoraphobia (17.2%), major depressive disorder (15.1%) and generalized anxiety disorder (10.5%). Women with CSR showed higher mean levels of cholesterol (169.2 vs. 159.2; p=0.017), high density lipoprotein (50.4 vs. 47.7; p=0.031) and low density lipoprotein (102.8 vs. 95.6; p=0.022) when compared to women without CSR. The adjusted regression model showed a higher prevalence ratio (PR) of CSR among pregnant women with generalized anxiety disorder (PR=2.70, 95% CI: 1.36-5.37), with ≥two parturitions (PR=2.46, 95% CI: 1.22-4.93), and with major depressive disorder (PR=2.11, 95% CI: 1.08-4.12). We have shown that generalized anxiety disorder, major depressive disorder and higher parity are associated with CSR in the first trimester of pregnancy.
    09/2013; 210(3). DOI:10.1016/j.psychres.2013.08.053
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    • "However, these estimates have been based on small psychiatric or drugdependent treatment high-risk samples (Birndorf et al., 2001; Copersino et al., 2008; Copersino et al., 2005; Newport et al., 2007). In a recent U.S. study of a community-based sample of pregnant women, the 14-day prevalence of antenatal suicidal ideation was 2.7% (Gavin et al., 2011), which was similar to the 12-month prevalence of suicidal ideation among the general population (Kessler et al., 2005). "
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    ABSTRACT: Introduction: Perinatal suicidality (i.e., thoughts of death, suicide attempts, or self-harm during the period immediately before and up to 12 months after the birth of a child) is a significant public health concern. Few investigations have examined the patients' own views and experiences of maternal suicidal ideation. Methods: Between April and October 2010, researchers identified 14 patient participants at a single university-based medical center for a follow-up, semi-structured interview if they screened positive for suicidal ideation on the Patient Health Questionnaire-9 (PHQ-9) short form. In-depth interviews followed a semi-structured interview guide. Researchers transcribed all interviews verbatim and analyzed transcripts using thematic network analysis. Results: Participants described the experience of suicidality during pregnancy as related to somatic symptoms, past diagnoses, infanticide, family psychiatric history (e.g., completed suicides and family member attempts), and pregnancy complications. The network of themes included the perinatal experience, patient descriptions of changes in mood symptoms, illustrations of situational coping, and reported mental health service use. Implications: The interview themes suggested that in this small sample, pregnancy represented a critical time period to screen for suicide and to establish treatment for the mothers in the study. These findings may assist health care professionals in the development of interventions designed to identify, assess, and prevent suicidality among perinatal women.
    Women & Health 07/2013; 53(5):519-35. DOI:10.1080/03630242.2013.804024 · 1.05 Impact Factor
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    • "Author's personal copy the prevalence of suicidal ideation/potential was similar to that found in the literature (Freitas and Botega 2002; Manber et al. 2008; Newport et al. 2007). "
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    ABSTRACT: Is important to evaluate suicidal potential and related factors during pregnancy among women who have attended public health services. To determine the suicidal potential, question 10 from Edinburgh Postnatal Depression Scale (EPDS) was used. In this sample (N = 1,334), 8.1% of pregnant women demonstrated suicidal potential. The potential risk factors for suicide in depressed pregnant women were being single, divorced or widowed, thinking about having an abortion, and having anxiety symptoms; in nondepressed pregnant women were lower age, low education level, low socioeconomic class, thoughts about having an abortion and anxiety symptoms.
    Community Mental Health Journal 03/2012; 48(3):392-5. DOI:10.1007/s10597-012-9495-0 · 1.03 Impact Factor
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