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

Article (PDF Available)inArchives of Women s Mental Health 15(1):39-47 · January 2012with33 Reads
DOI: 10.1007/s00737-011-0246-y · Source: PubMed
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.
    • "Finally, we investigated income and resilience as protective factors. In contrast to our hypothesis and consistent with the findings of Mauri et al. (2012), income was not associated with presence or severity of SI. By contrast, resilience was significantly associated with 4-months and 15-months SI. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: The current study extends our understanding of postpartum suicidal ideation (SI) in the context of childhood maltreatment (CM). The study longitudinally examines the prevalence and severity of maternal SI. We further examined risk and protective factors' associations with postpartum SI. Methods: SI was assessed at 4, 6, 12, 15, and 18-months postpartum in a non-clinical sample of mothers with CM histories (N=116). For the first aim, frequency, longitudinal percentage counts, and ANOVAs were conducted. For the second aim, logistic and linear regressions were completed to examine associations between risk and protective factors and the presence and severity of SI, respectively. Results: Endorsement of SI was highest at 4-months (37%) and remained at approximately 25% for the duration of the study. While the severity of CM was not significant, our sample of women with CM histories evidenced markedly higher rates of SI than other postpartum investigations. Resilience, marital status, maltreatment-related shame, and family support were associated with suicidal ideation or severity at some assessments; however, these relationships were highly variable over time. Limitations: of this study include the use of self-report measures and generalizability to mothers without CM histories. Conclusion: Mothers with histories of CM are at risk for postpartum SI. Our findings elucidate the importance of understanding the interplay and variability of risk and protective factors during postpartum. These results aid clinicians in identifying women at risk for suicidal ideation during postpartum.
    Full-text · Article · Jun 2016
    • "The data include continuous and discrete quantitative variables. The EPDS scores were tabulated according to the documented protocol (e.g., Cox et al., 1987; Mauri et al., 2012), including the actual number of positive answers and a cumulative score on each screen. Following accepted standards, a score of 10 or greater, of a possible total of 30, was used as screening positive for depression (Hanusa, Scholle, Haskett, Spadaro, & Wisner, 2008). "
    [Show abstract] [Hide abstract] ABSTRACT: This study uses prenatal clinical chart reviews of 245 women who were screened for depression while receiving antenatal care services at an urban hospital-based clinic in Syracuse, New York. The results indicate that more than one half of the mothers who screened positive are not being adequately referred and followed-up on to ensure they are receiving proper treatment. Among the mothers who are not being successfully referred are women who are non-English speaking, facing multiple life stressors, and inadequately insured. Recommendations for colocating services that may ease the ongoing burdens of new motherhood are addressed.
    Full-text · Article · Jun 2016
    • "Moreover , this risk might vary by evaluation time. Studies employing the EDPS found decreasing rates from the third (5.4 %) to the sixth (4.1 %) to the eighth (3 %) month of pregnancy (Mauri et al. 2012) and from the third (10.2 %) to the eighth (6.8 %) month (Evans et al. 2001). We found that AD increases CSR by 5.60 times [95 % confidence intervals (CIs)=2.82–11.11]. "
    [Show abstract] [Hide abstract] ABSTRACT: Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55 %. The overall CSR was 23.53 %, distributed across risk levels of low (12.55 %), moderate (1.18 %), and high (9.80 %). Our rates approximate those found in another Brazilian study (18.4 %). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95 % confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95 % CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95 % CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.
    Full-text · Article · Jul 2015
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